HomeMy WebLinkAbout6244 ROOKERY RD - APPLICATIONS - 3/27/2019 (3)C i'i y cr8 Planning, Development & Transportatlon
281 N. College Ave P.O, Box 580
Fort Collins CO 80524
Phone 970-416-2740 Fax 224-6234
c /ER -THE -COUNTER PERMITS ONLY
This application is t< ,li used to apply for the following permits only (check all that apply). X Air Conditioning
❑ Demolition (interior i-structural) ❑ Electrical Alteration (not service chEinge) ❑ Gas Lighter ❑ Gas Log
Heating Unit 1111-aur Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Wate r t eater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
(� manufacturer).
plete all appiical I information on the application. Incomplete applications will not be accepted.
(�1g03C3q►icat:ion # �l . 1 �3 (•— G%7%)�
far off, a 7'se only Date
Job Site Address (re,'u ed)(fz`k} koo" r 5 Value of Construction (labor, materials, profl D.46q
3rrnce I1 I lmar (,12q q} uo a FDYt Co M- U 8b5Z8 �?7D (�gZ-3873
Property Owner Name " Addres City/State 71 Pho--
2stcu�at�le 59.64 Lockheed Ate. I,ovY(�vid Go b�53g ��o'484n�y�lD
Applicant Name Address City/State ' ZIP Phone
Contractor r 1 — 5 .(-G'C zGi> UZIG� . GY s&..�•b' i (.01
Address JJ City/State
p1 f3 ;jy� �vrL ZipI1_.. i ; PhAone
-iL�.1• 1 '�� t `('-�-i i-y ��� t�VVKI�LLr_�((� LL�J '•Fi ,St .% 'v
Contractor City of Ft, G Ili is ales Tax # Are you paying taxes here or by report? ❑Here 1
S esra n m is required y, rllcontractors Are you paying with your trust account? eyes O No ort
Is this a residential or c ir ercial project? Residential ❑ Commercial If residential, is it:, i' Ile Family Detach d ❑ Condo/townhome (single family attached) ❑ Duplex
I is :ifamily (apartment) ❑ Garage
If commercial, is it: ❑ I `a < ❑Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ F e' aurant ❑ Other (ex lain) —
Is this building SD years i„ age or more? ❑ yes No If yes, you may neeAto contact Historic ion
If this is for a demolitiei ' zrmit, what year was the uilding constructed?
If prior to 1975,, you will , e d an asbestos assessment to submit with this appl/�tio
Description of work _ _ Q raP1 _ AALL. inn, 'u vin n e o .A�t nTs—
*If lawn
List the
I hereby acknowledge that
comply with all requiremen
permit is not valid until
Applicant:
Print foam
list licensed
If first-time A/C, must list licensed
name or City of Ft Coll/ns license fi
Mechanical_` Roofer
—� Other
read this to
alned herein at ndcity ordinances and state laws ion and state that the above nregulating buildingformation Is construction. I knowethat a
been paid and issued.
Signature
Date