Loading...
HomeMy WebLinkAbout3939 Rannoch St - Applications/Water Heater - 08/13/2013Aug•13. 2013 2:57PM 9704844448 ALLEN PLUMBING&HTG City of Foilq Co ns No,4485 P. 5/8 Planning, Deveiopment & Trans;)n taller, 281 N. College Ave P.O. Sog 580 Fort Collins, CO BOS24 Phone 970-416-2740 Fa;; 2246i34 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) 7 Gas Lighter Gas Loc ;�Ileafing Unit 11 ❑ Lawn Sprinkler ❑ Mobile Home replacement Hoofing -D Sewer Line r ?hoto-voltaic O Ventilations Hater Heater Water Line ❑ Wood/Peliet Stove (must be EPA; certified, provide make, model and manufacturer}, Complete all apOlitable information on the application. Incomplete applications wili not be accepted. Application # (so-! 274 UZIte ForofFice use only J00 Site A(3-4ra¢s treculred) rtv Owner NarmF Acidness ' .n bo-1 y 6& -,SAa, ant Name Address v I Value of Corst ruc5or (labor, materials, proff) ._ tag oa awstate MID Phone Pnan� Contractor t A,tdr�5 City/state- ?p anone Contractor City of Ft. Collins Sales T a, K rare you payinW —=es here or by report? L, =1ere �� Repo • _ Sales tax n ben regrfir2d fly a/r aD/JlidCto s r Are yo'u paying with your u USZ' aCCOunt , 3` ' "Aj i�o ' L(r..�. 4 � Ate' 41P Is this a residentia4'15ingle mmercla! projeG? �or�enGa! Commercial If residential, is Family betaCi� 0 Condo(townhome (tingle family attached, Ouofe;: uldfarnily (apartment) C] Garage If commercial, is It: Ci Bank ❑ Bar ❑ Church rJ HoteVMotel C1 Medical office • Ofnce O Retall ❑ Restaurant 0 Other (ex fain) Is this building 56 years of age or more? 0 Yes Na df yes, ynu rnayne to contact Nfseari; r'rese.-nation If this is for a demolition permit, what year was the riding constructed? If prior to 197S, you will new2an asbestos assessment to submit MV7 tf7is applicaaan, Description of work, elYID Of f h' Oahe tulI Ik a� _ WWI npnnKier/paCknow preventer, must list Ilcerued plumber. if BrSt_tl� mee MCMnusc rig- licensed c_+lertrriar. Subcontractors: List the company name ar Caey of t7 Callus license g SaCt ician Piumber Mechanical Roofer Other i hereby acknowledge that I have read this application and state that the above information is complete and corre�. . acee tc comply with all requirements.pontai0eocrein and city ordinances and state laks r0.90atin 0uildin - ' "' Permit ls'not'vat•i�d until it has been plaid and i_sued: 9 s constxu�io:,. . i:no+�.tn�: Applicant: 6irl 1 tJri� i Print Name. Signaiur