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HomeMy WebLinkAbout2307 Plains Ct - Applications/Mechanical - 11/25/2013From (303) 583-8348 Mon 25 Nov 2013 05:25:49 PM MST MST Page 1 of 1 City.Of Conine Planning, lDevelppment & Transportation 281 N. College Ave P.O. Box 580 Fort Collins, Co 8052.4 Phone 970-416-2740 Fax 224-6134 1 ! y This application is to be used to apply for the following permits only (check all that apply), C Air Conditioning 11 Demolition, (interior non. structural) O Electrical Alteration (not service change) 0 Gas L.ightar n Gas Log a teating Unit p Lawn, Sprinkler p Mobile Floma replacement CI Roofing 10Sewer Line O Photo-voitaic 0 Ventilation PYdater Heater 0 Water Line 0- Wood/Pellet Stove (must be EPA:certifed, provide make, model and manufacturer). Complete all applicable Information on the application. Incomplete applications will not be accepted. Application .Y#, 126oI 30(i2l G .__. Date - i For office use only -- Job Site Address (rquired)y w- Value of Construction (labor, mateiiais, profit) _ - -- Property Givner Name Address City/state Zip ^,,^ � : e- Phone # t i } iYjl t,:i�#�>:,,¢ +t ,.,< \x ApQir3tt'Name;'�):> Address Ci /5te 7_i ty Phone - p i _ Citractor t i Address City; State Zip _ Phone ` ; i,` lLZ _\...r t \ $..7.: C �!...-�^ i fl.:. 3 2L'—rev-y >. 1 ft i,�\:di: 'i —J"'`t �..`II { v A l`,.—_` i >,.i:\ Contractor City of Ft Coll Mi SKies.Tax # Are you paying taxes here or by report? FprHere ❑ Report -5-1ttBxnumberism7viredn;•a?},w6acrus. Are you paying with your test account? 0'� 0 No Is this a residential or commercial project? E Residential 0 Comrr`erciai If residential, is it: ,P�`S ngie Family Detached © Condo/tovinhorne (single family attached) 0 Duplex 0 Multifamily (apartment) 0 Garage ' If commercial, is it: © Bank © Bar 0 Church 0 Hotel/Motel Ci Medical office 0 Office 0 Retail © Restaurant © Other (explain) -- - - -- - ' Is this building 50 years of age or more? 0 Yes Cl W. If yes, you may need to conL-ct Historic Rresenation It this is for a demolition permit, what year was the building constructed? f prior to 11975, p:7u will need an asbestos to subrnit with this appii of}on. Description, of work XIf Eamon sp>inkler}backflow o4venter, must list licensed plumber, if first-tirne AIC, must list licensers eiertrician. Subcontractors: List Lyre company name or CM1 of Ft Ct Ili ns lice rse ll i re, , j'; ✓� a- -' Electrician--- _ Plumbers%, _ Mechanitaf.. rY . -4.— Roofer--- Other i I hereby acknoviledge that T 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 construction. I.know that a permit is not valid until it has been paid and issuer!. Applicant \ )e ; :� r Print Ntarne R��1?;� i.t i Signatue'3°"};� �j - - Date +