HomeMy WebLinkAbout1809 S TIMBERLINE RD - APPLICATIONS - 3/28/2019Fort Collins
Planning, Development, & Transportation Services
Collins Community Development & Neighborhood Services
° 281 North College Avenue
Fort Collins, CO 80524 Main: 970.416.2740 Fax: 970.224.6134
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 applicable information on the application. Incomplete applications will not be accepted.
Application # Date
For office use only
03/28/19
lob Site Address (required) Value of Construction (labor, materials, profit)
1809 S Timberline Road $3,623
Property Owner Name Address City/State Zip Phone
City of Fort Collins Light & Power 700 Wood St Fort Collins CO 80521 970.221.6326
Applicant Name Address City/State Zip Phone
George Stolz 3317 Lincoln Avenue Loveland, CO 80538 970.669.7609
Contractor Address City/State Zip Phone
Gregory Electric Inc 3317 Lincoln Avenue Loveland, CO 80538 970.669.7609
Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? IZ Here ❑ Report
sales tax numbe r is required by all contractors Are you paying with your trust account? ❑ Yes 13 No
Is this a residential or commercial project? ❑ Residential ® Commercial
If residential, is it: ❑ Single 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 M Other (explain) Substation
Is this building 50 years of age or more? ❑ Yes ❑ No If yes, you may need to contact Historic Preservation
If this is fora demolition permit, what year was the building constructed?
Description of work New 200A service to substation broadband building.
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or City 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.
er
Applicant:
Print Name: George Stolz Signature I Date 03/29/19
Revision date 2V2017