HomeMy WebLinkAbout4900 BOARDWALK DR - APPLICATIONS - 5/10/2018 (3)planning. Development & TransPortstion
City of 281 N. College Ave P.O. Box 580
ort Collins Fort COHIM, 80524
Phone 970-416-2740 Fax 224-6134
OVERaTHE-COUffER PERM17S ONLY
for the following permits only (check all that apply). ❑ Air Conditioning
is application is to be used to apply 0 Gas lighter f7 Gas Log
Demolition (interkx non-structuraq ❑ Electrical Alteration (not service change) ��r �e ❑ Pho6o-votm�
Heating Unit 0 Lawn Sprinkler 0 Mobile Home replacement ❑ Roofing make, model and
Vertfilation p-Water Heater 0 Water Line ❑ WoodlPellet Stove (must be EPA certified, provide
all appflaable informalft n the appy on.
:in #
For OffW Im OW
sloe Address (Irewd=7
Na rm
Oz
Eavlcc' Gv
ad -or City of Ft. Collins Sales Tax
tax numbed• mqu ked byR# owth'eCIM
Incomplete aP~ions will not be acoepted-
value of Cmtsbuction (labor, materials, Profit)
� ddress TSGS S • (5ty/st3tle Ot '�YtA Zip
DrzlLEtj vri. C 71 a CO
Address Cshr/stift zip
Address ZIP
7.DC Are ou �g � ytaxes our bust aoc .KYes 0 NO or by report? 13 Here ort
Is this a resideritial or commercial proJett? 1KRedderitial ❑ Cmmerdal
If residential, is it: Ogrigle. Family Detached 0 Condptownhome (single family attar ied) O Duplex
13 Multifamily (apartment) 0 Garage
If commercial, is it 0 Bank O rear ❑ Church ❑ Hotel/Mobel CI Medical office 0 office O Retail
13 Fbeslaurant 0 Other (explain)
Is this building 50 years of age or more? ❑ YeS D [ o If}4 you nrayttoed to contact Brit P
If this is fnr a demolition permit, what year was the building wnstructed?
Ifprior to 1975, you wdl need an asbestos meant to su[tmlt K t/i thIs applfr30tim
Description of work
*If lawn sprinkler/baddlow pmventer, must Pest licensed plumber. If first-fte AIC, must list licensed eledriclan.
SubGvnbwcbw= L jt Me company name ar aty afR Caft l NNO $
Electrician Plumber - - Mecrienkel Romer Odd
2.�
I hereby advlovdedge that I have read this applkatkin and state that the above Information Is complete and correct I agree mo
comply MM all regrdrements contained herein and city ordinances and state laws reguiadng building eonsMiction. I kmaw that a _
permit b not valid until it has been paid and kssud.
Dote � �b �(
9-d 91,170-Nt7-OL6 Auodwoo eotmes uuewlle d69:90'91, 9l feW