HomeMy WebLinkAbout5836 Mars Dr - Applications/Mechanical - 06/14/2013Jun 11 2013 04:28PM Albrachts One Hour 9706634097
page 2
Fort Collins
Planning, Development 5c 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 applicati n. Incomplete applications will not be accepted.
aS
Application # 130 0 r Date U -ILA- 13
For ofllce use only /Drl
Job Site Address (required)
rValue
of Construction (labor,
materials, profit)
5836 Mars Drive
$7930.00
Property Owner Name
Address
City/State Zip
Phone
Jason & Vanessa Vasa
5836 Mars brive
Fort Collins, CO 80525
970-222-215
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 24 Report
Sales tax number isrequired bya#contractors
Are you paying with your trust account?
® Yes ❑ No
Is this a residential or commercial project? ® Residential Cl Commercial
If residential, is it: ® Single Family Detached ❑ Condo/townhome (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 H/storic Preservation
If this is for a demolition permit, what year was the building constructed?
Ifprior to 1975, you will need an asbestos assessment to submit with this application.
Description of work Replace furnace and AC .
-, .... J`Ln,NCl/uabRllUW wcvvmer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or City of Ft Collins license 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 contalned 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- Stacey Schmidt '5 Selma Print Name: Signature Date 06/11/2013