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HomeMy WebLinkAbout2215 Puma Pl - Applications/Furnace - 12/20/20114 Fort Collins i 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 uaed to apply for the following permits only (check all that apply). 0 Air Conditioning 0 Demolition (interior non-structural) 0 Electrical Alteration (not service change) 0 Gas Lighter 0 Gas Log 17 Heating Unit 0 Lawn Sprinkler t7 Mobile Home replacement 0 Roofing O Sewer Line O Photo -voltaic O Ventilation O Water Heater 0 Water Line 0 Wood/Pellet Stove (must be EPA certified, provide make, model and manufacturer). Complete all applicable Information on the applicatiork Incomplete applications will not be accepted. Application # 61240093 P Date 12/20/2011 25. pp Forofi~ice use only Job Site Address (required) Value of Constructlon (labor, materials, profit) 2215 Puma PI $1662.00 Property Owner Name Address City/state Zp Phone Boo Pinson 2215 Puma PI Fort Collins 80525 420-4445 Applicant Name Address 'City/state Zip Phone Boo Pinson 2215 Puma PI Fort Collins 80525 420-4445 Contractor Address City/State ZIP Phone Gary Hooley Heating & Air 1314 Webster Ave Fort Collins 80524 493-3272 Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? 0 Here 0 Report Safes tar number& rcqu+iedbyall mmeanws Are you paying with your trust account? G Yes 0 No 34734 Is this a residential or commercial project? M Residential O Commercial If residential, Is it: 0 Single Family Detached O Condo/townhome (single family attached) O Duplex C MulUfamily (apartment) O Garage If commercial, is it: O Bank O Bar O Church O Hotel/Motel O Medical office O Office Cl Retail 13 Restaurant O Other (explain) Is this building SO years of age or morel ❑ Yes 0 No If yes, you may need to contact HlsWrIc PreserVat/on If this is for demolition permit, what year was the building constructed? If prior to 1975, you wffl need an asbestos asmssment to submit with this appilcatlon. Description of work -Replace F 4mnce *If lawn sprinkler/backflow preventer, must list licensed plumber, If first-time A/C, must list licensed electrician. Subcontractors: Ust the company name or dty of Ft Collins llh we 0 ElectrIclan Plumber Mechanical H-1654 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: Sheryl Johnson Print Name: ry Signature Date lli£'d b£Z9 b22 0L6:01 80Zib220L6 A3-100H:woad OS:it 2i02-b0-NUf