HomeMy WebLinkAbout4107 SUNCREST DR - APPLICATIONS - 7/30/2019city ,planning, Development, At Transportation Services
Fort Cothns 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 PKRoofing ❑ 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 # 2) RD S9 L9 Date
For olfice use only
Job Site Address (required) Value of Construction (labor, materials, profit)
L 7 u 4 ire CCU 5 5- t31o32,
Property Owner Name Address City/State ZIP Phone
t � H, l ftis C. o X625-3595 9y-07-S17
Applicant Name Address City/State Zip Phone
zpa matb "0 5- kw roar ' SL+k `Z %4- (U OSZS- -)0-66f-527
Contractor 2 3705- Address City/State Zip Phone
-Vt"�r&-D 517 A
Contractor City of R. Collins Sales Tax # Are you paying taxes here or by report? ere ❑ Report
sales tax number Isrequlredbyall contmctors Are you paying with your trust account? ❑ Yes �o
_t3O 1 2i'� 3? Cif
Is this a residential or co mercial project? Wesidential ❑ Commercial
If residential, is It: k 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 ❑ No If yes, you may need to contact HlstoricPreservadon
If this is for a demolition permit, what year was the building constructed?
Description of work 2IL4 9.5- ,:4tixres 2
c�jFo( w� r Iu55 �J f.Kau—fcv—`
*If lawn sprinkler/backfiow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: Ust the company name or City of Ft Collins license # ���ooen;�
Electrician Plumber J 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: � �+ �' 1
Print Name:y ; "'� �t9� lcR �l Signature Date l ��"
Revision date 216/2017