HomeMy WebLinkAbout2801 Pipestone Dr - Applications/Furnace - 10/25/2013Oct 15 2013 11:07AM Albrachts One Hour 9706634097
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Fort Collins
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
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
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stave (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application # B ( 3 0 G& 31 Date I D ' c? 5. 13
For ofce use only
Sob Site Address (required)
Value of Construction (labor, materials, profit)
2801 Pipestone Drive
$3025.00
Property Owner Name
Address City/State Zip
Phone
Steve Schmutzer
2801 Pipestone Drive fort Collins, CO 80526
970-221-1542
Applicant Name
Address City/State Zip
Phone
Albracht's One Hour Heating & Air
487 Denver Avenue Loveland, CO 80537
970-663-4002
Contractor
Address City/State Zip
Phone
Albrecht's One Hour Heating & Air
487 Denver Avenue Loveland, CO 80537
970-663-4002
Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report?
❑ Here 0 Report
Sales tax number isrcrquimdbyall contractors
Are you paying with your trust account?
C1 Yes ❑ No
Is this a residential or commercial project? RI Residential ❑ Commercial
If residential, is it: ® Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ 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 Historic Preservation
If this Is for a demolition permit, what year was the building constructed?
Ifpnor to 1975, you will need an asbestos assessment to submit with this application.
Description of work Replace 80K BTU furnace
*If lawn sprinlder/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or City of Ft Collins license .f
Electrldan Plumber Mechanical Roofer
Other
1 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 contalned 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: �+
Print Name: Stacey Schmidt Signature Stacey Date 10/15/2013
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