HomeMy WebLinkAbout602 Edwards St - Applications/Gas - Log, Line, Pipe - 01/27/2012JRN-27-2012(FRI) 15:08 P.001/001
City of Planning, Development & Transporta ' n
281 N. College Ave P.O. Box Sao'
Fort Collins 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 tho following pormlts only (check all that apply). Air ondWaning
Demolition (Interior non-structural) Electrical Alteration (not service change) Gas Lighter Gas Lo
Heating UnIt Lawn Sprinkler Mobile Home replacement Hoofing Sewer Lino Photo -voltaic
Ventilation Water Heater Water Line Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable Info
orrma
�tion on the application. Incomplete 3PPlicationswlll not be accepted.
Application n 1OWvL4_1Date 11 aeJ
For of ice use only
Is this a residential or commercial projea:I esldendal Commercial
If residential, is It- le Family Detach Condo/townhome (single family attached) Duplex
Multifamily (apartment) Garage
If commercial, is It: Bank Bar Church Hotel/Motel Medical orfice Office Retail
Restaurant Other. (explain)
Is this building 50 years of age or more? Yes No 16es, yvu may need to contacr Historic Preservation
If this Is for a demolition permit, what year was the building constructed?
It prior to 1975, yvu wil/ need an asbestos assessment to submit w/th this appl/cacion.
of
"If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician,
Subcontractors: ,Ust the Company name of C7ty of Ft Collins licens., t
Electrician _ �s Plumber, Mechanlrbl
Roofer. Other.
a nercuy acKnowieage tnat I have read this appllC,.1non and state that the abave Information Is complete and correcL I agree to
comply with all requirements contained hercln and city ordlnances and state laws regulating building construction. I know that
permit Is not valid until It has been paid and Issued.