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Home My WebLink About815 Napa Valley Dr - Applications/Furnace - 01/16/2013FROM :NCR FAX NO. :9702299983 San. 17 2012 12:1ePM P1/3 Fort Collins 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 all that apply). D Air Conditioning ❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log Heating Unit ❑ Lawn Sprinkler 0 Mobile Home replacement D Roofing ❑ Sewer Line ❑ Photo -voltaic ❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and manufacturer). Complote ail information, c.n (h;7 i3m)liG-nLioi'.. inC itYi7%yIC rtpplirafions will not hfs af'--GF tt,Ci. Application # e) 13 UD a S Le For otce use only Date - l Lo Jj ` (� ,...... Job Site Address (required) Value of Construction (labor, materials, profit) Q Oq 51 o� Property Owner N me Address City/State Zip Phone fn�m- pt 1� is S t, DM va I C.0 -82 S C1 Applicant Name Address City/ate Zip Phone Contractor Address City/State Zip Phone q � Vo _✓l� �.c Y1-, ' 1l S e. P+(-oil v Lo 2 aa3' Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? El Here IXReport Sales tax number is required by all conMactcus. Are you paying with your trust account? [KYes ❑ No .� (02- Is this a residential or c9mmercial project? eResidentlal ❑ Commercial tC�lh i•1i :t ��'• !I rl Fanl I i f ��n �fl '1'!'", Sin �i 1 .:�. ,' P'1 n 1 .. -d: 1 y' �iF�a.^.IIC'-1 � '...ii .il( �.IlilGnic ( "li'I�d �i.al l}"' d.lP: h(iCl; L :tea i1 �::r. ❑ Multifamily (apartment) ❑ Garage If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ©Medical office ❑ Office ❑ Retail 0 Restaurant 0 Other (le 'n) Is this building So years of age or more? 17 Yes No If yes, you may need to contact Historic Preservation If this Is for a demolition permit, what year was a building constructed?-- Ifprior to 1975, you wi// need an asbastos assessment to submit with this application. Description of work f -t *If lawn sprinkler/backflow preventer, must list licensed plumber. if first-time A/C, must list licensed electrician. Subcontractors: List the company name or Clty of R Collins license # Electrician Plumber Mechanical Roofer I hereby ackn- z' Is application and state that the above i. crmoly with s , rein and city ordinances and state -laws -. .