HomeMy WebLinkAbout220 Yale Way - Applications/Mechanical - 01/18/2013Jan 18 2013 05:45PM Gary Hooley Heat and Air 9702249198
page 2
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). M Air Conditioning
Q Demolition (interior non-structural) ❑ Electrical Alteration (not senricI changc) D Gas Lighter ❑ Gas Log
O Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing In Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, mode[ and
manufacturer).
Complete all applicable Information on the application. Incomplete applicatlons will not be accepted.
Application # 1? 1 ? 00 C9--q I pate January 18, 2013
For office use only
Sob Site Address (required)
Value of Construction (labor, materials, profit)
220 Yale Way
$7,253.00
Property Owner Name Address
City/State Zip •
Phone
Richard Ward 220 Yale Way
Fort Collins, CO 80525
482-9489
Applicant Name Address
City/state Zip
Phone
Richard Ward 220 Yale Way
Fort Collins, CO 8D525
482-9489
Contractor Address
City/State Zip
Phone
Gary Hooley Heating & Air 1314 Webster Ave.
Fort Collins, CO 80524
493-3272
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
D Here M Report
sales iaur°UMWisrevwredbyaamno-ac ors.
Are you paying with your trust account?
M Yes O No
34734
Is this a residential or commercial project? M Residential C7 Commercial
If residential, is it: p Single Family Detached ® Condo/townhome (single family attached) ❑ Duplex
Cl Multifamily (apartment) ❑ Garage
If commercial, Is it: C3 Bank Q Bar ❑ Church 12 Hotel/Motel ❑ Medical office ❑ Office O Retail
❑ Restaurant ❑ Other (explain)
]s this building 50 years ofage or more? ❑ Yes ❑ No If yes, you may need to contact Historic Pfeseryation
If this is for a demolition permit, what year was the building constructed?
lfprlor to 1975, you will need an asbwWs assessment to submit m7h this application.
Description of work Replace furnace and add 2 ton condensing unit -
ar rdwn spnnKreripaCKriow preventer, must list licensed plumber. Ir first-time A/C, must list licensed electrician.
Subcontractors: list the rompany name orcfty of Ft Collins license #
Ei8tridan Creekside plumber Mechanical H-1654
Roofer Other
I hereby acknovdedge 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:Shell S
Print Name: Shelly Signature
Date 0 1, 1