HomeMy WebLinkAbout525 E Plum St - Permits/Furnace - 11/08/2011of
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Site Address: 525 E PLUM ST
Job Valuation: $2,449.00 Category: Residential
Owner: FISHER, JESSICA C
787 CORONA ST 4
DENVER, CO 80218
Community Development & Neighborhood Services
281 N. College Ave Fort Collins, CO 80522
970.221.676o 970.224.6134 -fax
Building Permit #: B1110080
Issued Full: 11/08/2011
Permit Type: Residential Mechanical
Phone:303-903-4585
Zoning: Front setback: Rear setback: Right setback: Left setback:
Minor Amend #: Plat File #: ZBA Case #:
Zoning district: NCM - NEIGHBORHOOD CONSERVATION - MEDIUM DENSITY DISTRICT
Legal: Subdivision/PUD:
Code: Res sq ft: Com sq ft: _
# of stories: Occ Group: _
Fire Sprklr: Stock plan #: _
Contractor: SWAN HEATING & AIR COND., INC.
508 W 66TH ST
LOVELAND, CO 80538
Subcontractor(s) .
Mechanical SWAN HEATING & AIR COND.,
i
Work Description: REPLACE FURNACE.
Filing #: Lot #: Block #:
Ind sq ft: _
Const Type: _
Stock plan options:
Basement sq ft:
License #: H-1920 Supervisor cert #:
Phone: 970-215-5870
Phone License Number
9707215 5870 H-1920.
** SCHEDULE INSPECTIONS *** By Phone: 221-6769 *** By Web: http://amos.fcgov.com/CitizenAccess **
Inspections: GL FNM FNP FNE
TOTAL FEES PAID AS OF 11/08/11: $15.00 Payment method: Trust Account
As a condition for the issuance of a permit, I hereby declare that I am the owner or owners agent, authorized to perform the proposed work on the property described herein.
I agree to comply with all the requirements contained herein, and City ordinances, and State laws associated with such work. I understand that such permit may be
revoked in the event that issuance was based on incorrect information. This permit shall become null and void if the work authorized by such permit is not commenced,
suspended, abandoned or not inspected within 180 days from the date of such permit.
Carbon Monoxide Alarm required within 15 feet of each bedroom entrance.
Signature: Print Name:
Date:
Form Revised Oct 2010
Nov 08 11 07:41 a Swan Heating and Air
9706130826 p.2
City of Planning, Development & Transportation
Fort Collins For N. College Ave P.O. Box 580
Fort Collins,
CO 80524
Phone 970-41616-27402740 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
❑ D,e(iolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
EY'Neating Unit ❑ Lawn Sprinkler ❑ 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 # 1 `N \ lbU� 0 Date
For office use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
aLILI 1 0
Property Owner Name Address
City/State Zip
Phone 30 3
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eS o n
(-irn S+ ) ns 3CO3
3' -Lisa
Applicant Name Address
City/State Zip
Phone
Contractor Address
City/State Zip
Phone
Contractor City of Fe Collins Sales Tax #
Are you paying taxes here or by report?
❑ H�Je Import
Sales tax number is requiredbyallcontradois
Are you paying with your trust account?
Yes ❑ No
Is this a residential or coial project? ®'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 So years of age or more? ❑ Yes o If yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
If prior to 1975, you will need an asbestos assessment to submit with this application.
Description of work
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or Gty of Ft Collins license #
Electrician 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 state laws regulating building construction. I know that a
permit is not valid until it has been paid and issued.
Applicant: I
Print Name:L 1 l y- . Kb-d e �
Date E 1 Q Q�4