HomeMy WebLinkAbout7257 Fort Morgan Dr - Applications/Air Conditioner - 07/03/2013Jul 03 13 01:45p Swan Heating and Air 1 970-613-0826 p.1
City of
o
Planning, Development: & Transportation
281 N. College Ave P.O. Sax 580
Fort Collins, CO 80524
Phone 970416-2740 Fax 224-61M
OVER—THE-COUNTER PERMITS ONLY orNn9
This application is to be used to apply for the following permits only (check all that aPPly)-
rCflnd
0 Qeinoldion (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ PhotD-voRaic
❑ 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 applications will not be accepted.
Application #
t ✓� ���� -Date
Farc0fee ust'only
lob Site Address (raqulredj Value of Construction (labor, materials, profit)
Y 11 f I '-L-"'
property Owner Name
Address
��Y/5 Zip
Phoneme
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U
e
Phone
Applicant Name
Address
City/StateZip
contractor
Address
City/State Zip
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Phone GzU
2 j FJ$7 (
Are you paying taxes here or by report?
❑ H port
Contractor 4MY of Collu►s Sales Tax
#
Are you pig with your trust account?
L-t'Yes ❑ No
"es MrRumberisimubed 4rap mks
is this a residential or mrn at project? residential ❑ Commerdn ❑ Duplex
if residential, Is it Ingle Family Detached 0 Condolfnwnhome (single family attached)
❑ Multifamily (apartment)El Garage
If cornmerdai, is it Bank ❑Bar ❑ Chu ❑ Hotel/Mobal 0 Medical office ❑ office ❑ Retail
Restaurant ❑ other(expiain)
Is this Wading 50 years of age or more? ❑ Yes ❑ No If y2& you mayrteed ID confactffUu is PrewvaW17
If this is fora demolition permit, what year was the building eonsh>Lfted?
ffprror mY973, you will read an asL�s as�srnenttn submit with ifils aPP�
Description of worts
*If tarn sprinkler/bacidlow preventer, must list Iroerised Plumber. If first-time A/C, must list licensed electrician.
Subcontractors: L45tma cnmpanyname olGty.afITCalliri5ALMA W
flecina'"-----�— P1lAnt)E'r
Med>an+rai Roorer� Other
I hereby adQmwledge that I have read lfris ap and
t and state that the above irrfamlatiorr ibs ilding mr oand o� I�ow � a
comply rvdh all regdremerits mined herein and orty ar dinanoes and state laws raga sting
permit is not valid until it has been paid and issued.
Applimrl^ -7 - 3 - ZO f 5
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