HomeMy WebLinkAbout1809 ROSEMARY CT - APPLICATIONS - 7/22/2019City of Planning, Development, & Transportation Services
Fort 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). O Air Conditioning
❑ Demolition (interior non-structural) O Electrical Alteration (not service change) ❑ Gas Lighter O Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement Ai 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.
nfJ
Application # bI I O S Date
For ofce use only
Job Site Address (required) Value of Construction (labor, materials, profit)
1,90 AJL G-cS
f. &_0 —.
Property Owner Name Address City/State Zip Phone
J b aCtA r•� -f $°` ..osb.t„-Ar+-� �G S z8� 7a - ZzG - o
Applicant Name � Address City/State Zip Phone
CJIYS JO S")AnIC IBC_ X �� 70-2e1—i5020
Contractor Address City/State Zip Phone
o-Irjr" 17i- Los — ZL
Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? Jbii'Here ❑ Report
satestax number is required by all contactors. Are you paying with your trust account? )Yes ❑ No
Is this a residential or commercial project? ,�( Residential ❑ commercial
If residential, is it: Single Family Detached ❑ Condo/townhome (single family attached) ElDuplex
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 WNo If yes, you may need to contact Hisladc Preservation
If this is for a demolition permit, what year was the building constructed?
Description of work n"00Z, AN4 ACP�A-CC 322 SQ,Ar4-" o-F A-5 Ptap-t-r Sr+,.J6I CS
,.+,t O�Sao- �rw�,uL Fa�.X t1C Ct,,s-Ss �l 5.J-,o6 s6_s
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: Llst the mmpanyname or G'fy of Ft Collins license #
Mectridan 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: Prins Name: �•� ,SowoS.J Signature Dale ZZ.
\J
R.AW.. d.. vrvzorr