HomeMy WebLinkAbout724 Bramblebush St - Applications/Furnace - 03/07/2013Mar 07 2013 01:41PM Albrachts One Hour 9706634097
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Frof
t Collins
Planning, Development 8e 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). ❑ Air Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ 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 applicatlons will not be accepted.
Application # p���CI�?�� Date 3-1
For office use only
Job Site Address rrequired)
Value of Construction (labor, materials, profit)
724 Bramblebush Street
$2600.00
Property Owner Name
Address City/State ZIP
Phone
Cody Geisendorfer 724 Bramblebush Street Fort Collins, CO 80524
970-980-5429
Applicant Name
Address City/State Zip
Phone
Albrecht's One Hour Heating & Air
487 Denver Avenue Loveland, CO 80537
970-663-4002
Contractor
Address City/State Zip
Phone
Albracht's One Hour Heating & Air
487 Denver Avenue Loveland, CO 80537
970-663-4002
Contractor City of Ft. Collins Sales Tax
# Are you paying taxes here or by report?
❑ Here 29 Report
sales tar number is required by allconoaat s.
Are you paying with your trust account?
IN Yes ❑ No
Is this a residential or commercial project? ® Residential ❑ Commercial
If residential, is it: ® Single Family Detached ❑ Condo/town home (single family attached) ❑ Duplex
❑ 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 ❑ No If yes, you may need to Contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
/f prior to 1975, you will need an asbestos assessment to submit with this application.
Description of Work Replace furnace
it lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the companyname or City of Ft Collins license .d
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 knowthat a
permit is not valid until It has been paid and Issued.
Applicant: ,\
Print Name: Stacey Schmidt Signature +� (( iJ''l - '' y c_ IA Date
03/07/2013