HomeMy WebLinkAbout3212 Grovewood Dr - Applications/Mechanical - 12/28/201112/28/2011 06:51 F.A?t 970 686 6087
AMERICAN AIR HEATING INC - CITY OF FT COLLN 0 001
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Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970-416-2740 Fax 2-24-6134
OVER-THE-COUNTER PERMITS ONLY
This application is to be used to apply for the following permits only (check all that apply). El Air Conditioning
❑ Demolition (interior non-structural) C] Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
CrHeating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement Q Roofing ❑ Sewer Line C] Photo -voltaic
❑ Ventilation 2'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 #�j Date Jz - 2 s -//
F3roh9ce.use only
Job Site Address (required) Value of Construction (labor, materials, profit)
Is this a residential or commercial project? ffResidential ❑ Commercial
If residential, is It: B-Single Family Detached O Cando/townhome (single family attached) ❑ Duplex
4 Multifamily (apartment) Q Garage
If commercial, Is it: ❑ Bank ❑ 8ar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ office ❑ Retail
O Restaurant 13 Other (explain)
Is this building 50 years of age or more? ❑ Yes ffNo If yes, you may need to contact Hlstor/c Preservat/on
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 applicat/on.
Description of work Steel« F rn,,
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/c, must list licensed electrician.
Subcontractors: List the company name orrity of Ft Goll/ns license #
Dectrlclan n r �Cd ` e e, 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: �� t
Print Name: r�l Y f!/ Signature _ Date JZ - 2 9