HomeMy WebLinkAbout1427 Glen Eagle Ct - Applications/Mechanical - 06/11/201306/11/2013 07:31 FAX 970 686 6087 AMERICAN AIR HEATING INC 4 CITY OF FT COLLN R 001/001
Planning, Development & Transportation
city of /l/`� 281 N. College Ave P.O. Box 580
FVrt Collins itt-4. Fort Collins, CO 80524
/r�r ( Phone 970-416-2740 Fax 224-6134
Y_ .
OVER-THE-COUNTER PERMITS ONLY
This application is to be used to apply for the following permits only (check all that apply). ErAir Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
ET'Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line 0 Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application # 313Dc28-3S Date
for office use only eggq 01 n
Job Site Address (required) Value of Construction (labor, materials, profit)
)Yap Lnri r6t4& C $ /2 3;25
Property Owner Name Address
City/State Zip
Phone
Applicant Name Address
City/State Zip
Phone
Contractor Llc # Addres/s�
City/State Zip
Phone
q 4 �1
ymr�laK Llri � #-17 / 52((�= trarateh (fir. #� %�rn�SOr. �0. 0 U 5 �0
q7U &�&
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
Mere ❑ Report
oles=number15requiredbya1fLW&a= S •�3tt/
Are you paying with your trust account?
des 0 No
Is this a residential or commercial project? 0'esidential 13 commercial
If residential, Is it: Ef Single Family Detached E7 Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) U Garage
If commercial, is It: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant O other (explain)
Is this building SO years of age or more? ❑ Yes [R'No If yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
ifpfior to 1975, you wi// need an asbestos assessment to submit with this application.
Description of work F. .6ce. _ AA-_
*If lawn sprinlder/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontr'ctors:List the Company name or Oty of R Collins license #
Electrician W i wed/e C , 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 �r( / S(L/ Print Name: `� "� r�`�"'-� ! Signature Date ��