HomeMy WebLinkAbout449 Flagler Rd - Applications/Water Heater - 03/08/2012Mar 08 12 03:20p Air Masters LLC
9705322006 p.1
Fort of
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970-416-2740 Fax 22+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 -
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
.
❑ Ventilation Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
f t r)
manu ac ure .
Complete all applicable Information on the application. Incomplete applications will not be Iaccepted.
Application # �� �o I Date 4 ' 4-43 VA
For office use only
Sob Site Address (required)
Value of Construction (labor, materials, profit)
45
yy9
Property Owner Name Address City/State Zip
606)11-tz- yyq Flue I-er %701. Gt•C1�1/,�s G'.525
Phone qX
4-9;2'777
LAad
.C'U
Applicant Name
l—ITdi ft°rs L c c.
Address OWState Zip
qI ivo w 1-/"? j j ttj a Id lid, Cv Y, -5 7
Phone 0-70
552 ,7&iV
Contractor
Address City/State Zip
Phone (f 70
Ir17%ll-Slet's LLC
i9g6 j1v—I .S LGvelezl? � /�0 YCS '7
53276/3
Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report Here ❑ Report
sales tax number is required by all contractors.
Are you paying with your trust account_ Yes
❑ No
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I't'U I'L{' %'� % iYl, l�'..G1/J,Z. (:i�.C',E y7G" S �3" • %Cr / �'
Is this a residential or commercial project? XResidential ❑ Commercial
If residential, is it: k Single 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)
O d
Is this building 50 years of age or more? Yes J^� No Ifyms you may need to contact Historic Preservation
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 wiM this appitcahon.
Description of work
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1�
*If lawn sprinklerJbackflow preventer, must fist licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or G'ty of Ft Collins license # /
Electrician 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: �,, �<(�� � i n a r�
Print Name: J_(iLl 1 b n Signature v Date