HomeMy WebLinkAbout2906 Alamo Ave - Applications/Furnace - 12/18/2013Forrt Collins.
Planning, Development & Transportation
281 N.. College Ave P.O. Box 580
Fort.Colllns, CO 80524
Phone 970-416-2740 Fax 224-6134
OVER-THE-COUNTER PERMS ONLY
This application is to be used to apply for the following permits only (check all that apply). ElAir Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler 0 Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ 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 # F21 30(05_(0Z Date 12,11ELi
For offike use only
Sob Site Address (required)
Value of Construction (labor, materials, profit)
arno
b
Property Owner Name Address
aty/state ZipPhone
-q7d •'
Applicant Name Address
CltyJState 'Zip Phone
Y
Contractor Address
CItyJSlate. Zip Phone
c Z--c
a, G o 8 052, Y 596: LM V
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report? ❑ Here AKAeport
Sales tax numberis*vired'byallcontradcrs
Are you paying with your trust account? PfYes ❑ No
Is this a residential or commercial project? YResidential ❑ Commercial
If residential, Is it: Ingle Family. Detached ❑ Condo/townhome (single family attached) ❑ Duplex
7 Multifamily (apartment) ❑ Garage
If commercial, is It: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ElMedical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (eXeLilding
)
Is this building 50 years of age or more? ❑Yeso Yyes, you may need to contact h+ist 17CPresenotron
If this is for a demoiltlon. permit, what year was consttticted?
If pnor to 1975, you will need an asbestos assessment to submit with lick appllcatfon,
Description of work
'If lawn sprinkler/badiflow preventer, must list licensed plumber. If first-time A/C, must list
Subcontractors: Ust the company name or City of R CoAlhs license 4 , ...
Electridan Plumber
MedtahidaLHJ 2869' Roofer
electrician.
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 state laws regulating building constiucdon. I know that a
permit is not valid until It has been paid and issued.
Applicant: r/
Print Name:. I (.� �% E ��2 -C- ..:signature - O� .��_ � �ij� Date