HomeMy WebLinkAbout5922 Venus Ave - Applications/Furnace - 07/10/2012•i
•Planning, Developtinent &Transportation
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281 N, College Ave P!0. Box 58.0
Fort.Collins, CO 80,524 l
A. Phone 970-416-2740 Fax 224-6134
OVER-THE-COUNTER PERMITS ONLY
This application. is to be used to apply for the following permits only (check all that apply)-.0 Air, Conditioning
❑ Demolition (interior Lion,structural) 0 Electrical Alteration (not service change) .❑ Gas 4ighter ❑. Gas Log
*dating Unit U Lawn Sprinkler O Mobile Home replacement q Roofing ❑•Sewer Une ❑ Photo -voltaic
❑ Ventilation 0 Water Heater Q Water Line ❑ WoodiPellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable, information on the'ap lication. Incomplete applications will not be accepted.
Application # Date
F-orno69ce use only
Is this a residential or commercial project? ,UCkpsidential ❑ Commercial
If residential, is It: Single Family Detached- ❑ Condo/townhorne (single family attached) ❑ Duplex
❑ Multifamily (apartment) U,Ga?age
If commercial, is it: ❑ Bank ❑ Bar .Q`ChunEh Cl Hotel/Motel ❑ Medicaloffice ❑ Office O Retail
U. Restaurant. ❑'Other (explain) .
Is this building 5o years of age or more? O Yes KNo tfyes, youmayneed to contactHIstdrlcPitseiwatlon .
If this Is for a demolitionpermit, what year was the building constructed?
yfpdorto 1975, you w0%needan asbestos assessmenttosubm/t'wlth thls.app#/cab'on.
Description of work
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*If lawn sprinkler/backilow preventer, must list licensed plumber. If first-time A/C, must list Ucensed, electrician..
Subcontractors: Ustthe company name orCity ofFtCollins license I
Electridah_ Plumber Mechanical )4.—Jy Z? Roofer.T_. Other
I hereby acknowledge that I have read this application and stafe.that the above Information is complete and rnrrect..I agree to;
comply with all requirements contained herein and city ordinances and state laws�regulaUn' g building construction. I know: that a
permit is not valid until it has been paid and,Issued-,
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Print Date ge
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