Loading...
HomeMy WebLinkAbout1625 W Elizabeth St - Applications/Water Heater - 01/17/201401/17/2014 10:28 9704612413 KAHAR PAGE 01 City.of Planning, Development & Transportation 281 N. College Ave . P.O. Box 580 � Fort CChins 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 parmks only (check all that apply). © Air Conditioning ❑ Damotition (interior non-structural) ❑ Electrical Alteration (not service change) i7 Gas Lighter 13 Gas Log ❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Ltne ❑ Photo -voltaic q Ventilation Q Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and manufacturer). . Complete all applicable information on the appiid6tion. Incomplete applications wiiii not oe accepted. Application # L3 / zlooz" Date 1 -1 7-1 4 For office use only lob Site Address (required) Value of Construction (labor, materials, profit) 1625 W. Elizabeth BID L $ 2,34.5.00 Property Owner Name Address City/State Zip Phone Faith Pro erty Man " merit 300 Boardwalk Drive 970-567-7473 Applicant Name Address City/State Zip phone 970— Keith A. Gallagher 6772 N. Franklin Avenue Loveland CO 80538 461--2412 Contractor Lic # MP-37 Address CIVState Zip Phone 9 7 0 - Kahar Plumbing & Heating, Inc. in Love a. rrCland. CO80538 Avenue. Love 461--2412 Contractor City of FL Collins Sales Tax # 18874 Are you paying taxes here or by report? ❑ Here P Report sales tax number IsiWuradbyall conmacrr»s Are you paying with your trust account? W Yes ❑ No Is this a residential or commercial project? 23 Residential Cl Commercial If residential, is it: ® Single Family Detached Li Condo/townhome (single family attached) ❑ Duplex 0 Multifamily (apartment) ❑ Garage If commercial, is it: ❑ Bank ❑ Bar 0 Church Li Hotel/Motel ❑ Medical office ❑ Office 0 Retail 0 Restails?nt; . rl Is this building 50 years of age or more? M Yes O No ffyes, you may need to contactHlstbrle Preservation If this is for a demolition permit:, what year was the building constructed? .ffprlor to 1974 you W11 need an asbestos assessment to submit wltlt this appllmtlon. Description of work Replace water heaters w/75 Gal - *If lawn sprinkler/backnow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician. Subcontractor;: List the company name or City off Collins l tense 4 6lectridan plumber Mechanical hoofer Other I hereby acknowledge that I have read this applIcatlon and state that the above informatbn is mnipiete and correct. I agree to comply with all requirements contained 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: Signature Pate /J n- H