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HomeMy WebLinkAbout4542 Maxwell Dr - Applications/Water Heater - 08/13/2012Aug 13 12 09:53a Hahn Plumbing 9704935325 p.2 City oT On cottins Planning, Development & Transportation 281 N. College Ave P.O. Box 580 Fort Collins, CO 80524 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 al[ that apply). C3 Air Conditioning . ❑ Demolition (interior non-structural) 17 Electrical Alteration (not service change) CJ Gas Lighter © Gas Log ❑ Heating Unit ❑ Lawn Sprinkler -0 Mobile Home replacement ❑ Roofing ❑ Sewer Line O Photo -voltaic ❑ Ventilation © Water Heater Water Line ❑ Weod/Pellet Stove (must be EPA certified, provide make, mode[ and manufacturer). Complete all appli cable iinffo'�rmatioonn jon the application. Incomplete app[icaiions will not be accepted. Application # l� Date — 50 For office use only • Is this a residential or commercial project? 'kResidential © Commercial If residential, is it: '_Single Family Detached 17 Condo/townhome (single family attached) • ❑ Duplex ❑ Multifamily (apartment) 0 Garage Ir commercial, is it: © Bank ❑ Bar © Church © Hotel/Motel 0 Medical office © Office Cl Retail 0 Restaurant 0 Other (explain) Is this building 5o years of age or more? O Yes O No rfyeT youmayrreed to conta4tHistoricPreservaiion If this Is for a demolition permit, what year was the building constructed? %'prior to 1975, you will need an asbestos assessment to submit with thls application. DescF on ofwo k k9- rinkler/backfow preventer, must list licensed plumber. If First-time A/C, must list licensed electrician. Subcontractors: List the company name orCltyofFtCoMnslkw2se 0 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: c - Print Name: -J r') 1 L . ilc`i gnatur�flate