HomeMy WebLinkAbout1703 Pecan St - Applications/Furnace - 03/17/2014City of
Fort COthns,
OVERaTHEnCOUHTEE
This application Is to be used.to. apply for thi! •following Of
❑ Demolition (interior non-structurai) .0 Electrical Alteration (rn
❑ Heating Unit ❑ Lawn Sprihkler .d Mobile Home replaceme
❑ Ventilation El Water Heater' 0 Water Line ❑ Wood/Pellet I
manufacturer).
Complete all applicable information on the application. Inc
Application # �1.4021A Z
Ar ofte use only
Plannitig, Development &Tramportatiion
201 N: College AveR0, Box 580 .
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
PERMITS'ONLY
its only (check all that apply}. ❑ Air Conditioning
service change) '13 Gas Lighter ❑ Gas Log
O Roofing ❑ Sewer Line ❑ Photo -voltaic.
we (must be EPA certified; provide make, model and
nolete applications will not be accepted.
Job Site Address ( uraao+j
Value of Constru Io�LJ eel profit)
PrJ�py Owner a Add
A�
City/Sta Phone'%
ipaft'
Applicant 4me ` Address City/State Zip Phone
c14a ?C>70
Contractor, .Address
F�f f x P:a/Yi.m crCe..
City)Stao Zip. Phone
/� " D �Dd:;':�9 D 'I tea`
..
,
Contractor City of Ft Cdiling:Sales Tax # ,
Are you paying taxes herie or by report? ❑ Here ❑ Report
s�esrarnxa�s eym�.ce»eacdrs.
�Q
Are you paying with your trust account? ❑ Yes ❑ No
Is this a residential or commerc1al.project7 • Mial O'Commercial '
If.residential, is.ib 17 Single Family Detached ndo/Eownhome (single family attached) ❑.Duplex
❑ Multifamily'(aparbnent) ❑ Garage .
If commercial, is it; ❑ Bank 0 Bar. ❑ Church ❑ Hotel/Motel ❑.Medi®I office ❑ Office ❑ pretail
❑ Restaurant IjOther (explain) _
Is this building 50 Vee rs of age or mom?: ❑ Yes f30o if yar, you may need m contactHesturk t1:l,4 rrabbn
If this is for a demolition permit, what year was the building mnstructied?
if error m i97S, you wry/n�an ar6esms ass+Esamenr h� suLmir with tha e�v!+�r,tlon,
Description of work
W
If. lawn sprinkla/hxkfiow pre must list licensed plumber. If first-time A/C, must list licensed electrician,
Subcontractors: Lftftcompanyiaan>e.arCRyofRealiivIIAWale,#„•'"
Electrlciaq� Plurrber MecNricd H/uoq ,Reofer Other
I hereby acicrowledge that I hieve read thle application and scats that tire' above tnkmnatlon is complete and correct, I agree to
comply with all rettulreMenta cGhbilned hereh and city ordinances and state laws reguluuni building construction, x brow that a
permit Is not valid until It hes'been paid and issued.
Applicant: � • . ft, 1
Print Name: natuAmft pate 7