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HomeMy WebLinkAbout410 E Pitkin St - Applications/Furnace - 11/08/201311/08/2013 08:31 FAX 970 686 6087 AMERICAN AIR HEATING INC 3 CITY OF FT COLLN IRj001 / Planning, Development & Transportation City of pl" l 281 N. College Ave P.O. Box 580 F6rt Collin l Fort Collins, CO 80524 % r �, ( 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 YHeating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line © Photo -voltaic El 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 # 7b { 6C2(Q 1 _ Date For etrice use only Sob Site Address (required) Value of Construction (labor, materials, profit) $ /4,,Z5 Property Owner Name ve4e4A Address 74,uVew,6,J City/State Dr• F.C. Zip d��5 Phone 5��4- 7 Applicant Name Address City/State Zip Phone Contractor Lic # Address City/State Zip Phone %rnet-; 'fn 4�G- #-17?i9 5!p t F r'ardeh r. 4 F WrrXiSur, ee- eUs O 170 6r6DS Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? here ❑ Report 'ales tax numcWisregryledpya//mntracwm ` 9' yf Are you paying with your trust account? Yes ❑ No Is this a residential or commercial project? 171-gesidential ❑ Commercial If residential, [sit: IT -Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex ❑ Multifamily (apartment) ❑ Garage If commercial, is it: ❑ Bank ❑ Bar Q 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? If prior to 1975, you W// need an asbestos assessment to submit with Mis application. Description of work pte,2)u Fkrna. - *If lawn sprinkler/backflow preventer, must list licensed plumber. If firs# -time A/C, must list licensed electrician. Subcontr11a��ctors!Ust die company name or City of Ft Collins. license # Electrician W r lea!e e, 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 skate laws regulating bulking construction. I know that a permit is not valid until it has been paid and issued. Print Name: �'iy1 t� l� Signature lza Date