HomeMy WebLinkAbout449 Flagler Rd - Applications/Air Conditioner - 06/04/2013Jun 04 13 08:23a Swan Heating and Air
970-613-0826 p.1
of
Fort Collins
Planning, levdopment & Transpwriaiion
281 N. Co➢ege Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
OVER-THE-COUNTER PERMfTS ONLY
This application is to be used to apply for the following permits only (check all that apply). Air Conditioning
❑ Demoli ion (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter 0 Gas Log
❑ Beating Unit ❑ Lawn Sprinkler ❑ Mobrle Home replacement LI Rooting ❑ Sewer Line ❑ Photo-voWc
❑ Ventilation C1 Water Heater ❑ Water Line ❑ WoodlPellet Stove (must be EPA certified, provide make, model and
manufacturer) -
Complete all applicable hiforrm�ationn on the application. Incomplete applications will not be accepted.
Appfication # 1✓' 7[/�l�V -Date Lo 7D
Faros rose only
lob Site Address (required)
Value of Construction (labor, materials, Profit)
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Property !Name
Address wstate Zip
Phone
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Applicant Name
A&k6 wstate Zip
Phone
Contractor
Address . Gty/State Zip
Phone 9-7 (3
Contr-actor City of
➢ins Sales Tic # Are you pay>ng taxes here orby resort? ❑ H
_ l�'�eprnt
❑ No
saies&rnrm76erlsrequ6edbYaimwlradms
Are you paying with your trust account? C!'yes
isWsa residential or pm3ecO Residential ❑ Conmmerdal
if residential, Is it: 5Ingte DIY Detached ❑ Condo/to++'mhome (single family attached) ❑ Duplex
❑ Median (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ HcW/Motet ❑ Medical office Q office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is ties building 50 years of age or more? 0 Yes a Ifpes, you mayneed tv mr>�ciffistaiic Pievation
if this is fcr a demolition permit whErt year was the building constructed?
IfpriorIU 197s, yw wNneed an asbestusassemnent tosubmit w0 OW APplf7an.
DesdWon of work
*If lawn sprii.&Wfbadd low preventer, must rst 6cerued plumber. if first-time Pic, must ust soOnnsea u I, sum',
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pwirrriae Ph]roW Medranicat _ Roofer Other
I hereby admovdedge that I have read this application and state that the above Wormation Is complete and cm ecL I agree to
omtply wo all requIranents oontained herein and city ordinances and state laws regulating building construction. I know that a
perm[t Is not valid until it has been paid and issued.
FAN