HomeMy WebLinkAbout4437 Viewpoint Ct - Applications/Furnace - 03/04/201403-06-14;08:OOAM; ;970-484-4448 # 13/ 13
Fort Collins
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
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 permits only (check all that apply). ❑ Air Conditioning
13 Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo-voltalc
❑ 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:& 0 1 '7S5- Date
For office use only
Job Site Address required)
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Values of Construction (labor, materials, profitt) D0
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P3perty Owner Name
Address
City/State Zip
Phone
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City/State Zip
Phone
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Contractor City of FL Collins Sales Tax #k
Are you paying taxes here or by report?
❑ Here PReport
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Are you paying with your trust account?)&Yes
❑ No
Is this a residential or c mmerdai project? (S Residential ❑ Commercial
If residential, is it: ASingle 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 50 years of age or more? ❑ Yes ❑ No Ifyes, you may need to contact HistodcPtesawt/on
If this is for a demolition permit, what year was the building constructed?
If poor to 1975, you Will need an asbestos assessment to submit with this application.
Description of
*If lawn sprinkler/backffow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the companyname or L7ty of Ft Collins Ilcanse #
Electrician Plumber Mechankal 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:
Print Name: r► _ n Signature
Date 3-qq