HomeMy WebLinkAbout425 SKYSAIL LN - APPLICATIONS - 6/25/2018City of
Fort Collins
Planning, Development & Transportation
281 N College Ave P O Box 580
Fort Collins, CO 80524
Phone 970 416 2740 Fax 224 6134
OVER-THE-COUNTER PERMITS ONLY
This application is to be used to apply for the following permits only (check all that apply) ❑ Air Conditioning
❑ Demolition (interior non structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified provide make model and
manufacturer)
Complete all applica le MAQ
mation on the application Incomplete applications will not be accepted
Appllcatlon # Date (,z- 5-/1 8
For o>fIce use only
Job Site Address (required)
Value of Construction (labor materials profit)
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Property Owner Name
Address
City/State
Zip q P o Phone
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Applicant Name
Address
City/State
Zip ���`' Phone
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Address
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Zip Phone
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Contractor City of Ft Collins Sales Tax #
Are you paying taxes here or by report? ❑ Here ❑ Report
Sales tax number is required by all contractors
Are you paying with your trust account? ❑ Yes ❑ No
Is this a residential or co mercial project? ®'Residential ❑ Commercial
If residential, is it Zngle Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial is it ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explai
Is this building 50 years of age or morel ❑ Yes �No If yes you may need to contact Histonc Preservation
If this is for a demolition permit what year was the building constructed?
If prior to 1975, you will need an asbestos assessment to submit with this application
De cripti n of work _ 04 5k1 lee s /A - /Zam jC w Cl pe-4" ..,
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*If lawn sprinkler/backflow preventer must list licensed plumber If first time A/C must list licensed electrician
Subcontractors List the company name or Gty of Ft Collins license #
Electrician Plumber Mechanical Roofer Other
I hereby acknowledge that I have read this application and state that the above information is complete and correct I agree to
comply with all requirements contained herein and city ordinances and state laws regulating building construction I know that a
permit is not valid until it has been paid and issued
Applicant (/ S �,/
Print Name /LQ �� Signature Date 2r