HomeMy WebLinkAbout808 SNOWY PLAIN RD - APPLICATIONS - 7/24/2019`ar to Inning, Development, & Transportation Services
®®��lil� 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 #
For office use only
Date hNQ L4 I I i
Job Site Address (required) Value of Construction (labor, materials, profit)
gob P1ck: R.a � 57 � • coo
Property Owner Nam Address City/State Zip Phone
F G 0- o a
Applicant Name Address City/State Zip Phone
C d " 7 G-la-1-6-77
Contractor Address City/State Zip Phone
Q AbnrofAQo Lu53'7 97041, 7.1. i -7-7
Contractor City of Ft. Collins a s 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? KYes ❑ No
-'I1oy`1
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 ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes gNo Ifyes, you mayneed to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
Description of work -XiN \ N�
Q S (zc�c,�( -' c Iash ► u
*If lawn spr ler/backflow preventer, must list licensed pjumber. `If first-time A/C, must list licensed electrician.
Subcontractors: Listthe companyname 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.
Applicant:
Print Name:TW%0_ Signature Date r7 a 19
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Revislon date 2/6/2017