HomeMy WebLinkAbout4302 Gemstone Ln - Applications/Furnace - 05/30/2014May 30 2014 08:02AM Gary Hooley Heat and Air 9702249198
page 2
Fort Collins
Planning, Development & Transportation
261 N. College Ave P.O. Box 580
Fort Collins, CO 8D524
Phone 970-416-2740 Fax 224-6134
OVERmTHE-COUNTER PERMITS ONLY
This application Is to be used to apply for the following permits only (oheck.all that apply). 0 Air Conditioning
Ct Demuatlun (Interlur non-structural) D Electrical Aneratlon (not service change) O uas ugnter ❑ t398 Log
O Heating Unit 0 Lawn Sprinkler 0 Mobile Home replacement O Roofing 0 Sewer Line 0 Photo•voltalc
O Ventilation 0 Water Heater G Water Line 0 Wood/Pellet Stove (rnual be EPA certified, provide make, model and
manufacturer).
Complete all applicable Information on the application. Incomplete applications will not be accepted.
Application # SI402(t�41
For ofte rrss any
Date 5/30/2014
lob Side Address (requked)
Value of Construction (labor, materials, profit)
4302 Gemstone Lane
$1664.00
Property Owner Name Address
Cty/State Zip
Phone
Bob Loner 930 Sailors Reef
Fort Collins, CO 80525
231-2222
Applicant Name Address
City/State ZIP
Phone
Bob Loner 930 Sailors Reef
Fort Collins. CO 80525
231-2222
Contractor Address
Qry/State Zip
Phone
Gary Hooley Heating & Air 1314 Webster Avenue
Fort Collins, CO 80524
493-3272
Contractor City of Ft Collins Sales Tax #
Are you paying taxes here or by report?
0 Here O Report
sales tax wwher is mwkad by aff mnhaornm
Are you paying with your trust account?
M Yes 0 No
34734
Is this a residential or commercial project? 0 Residential O Commercial
If residential, is it: 0 Single Family Detached 0 Condo/townhome (single famgy attached). 0 Ciuplex
O Multifamily (apartment) O Garage
If commercial, is It: ® Bank 0 Bar 17 Church G Hotel/Motel O Medical office O Office 0 Retail
G Restaurant 0 Other (explain)
Is this building 50 years of age or more? ❑ Yes ONO 1f ye4 you may need to =Wct Historic PYpservatlon
If this is for a demolltion permit what year was the building constructed?
if prior to 1975, mu wlAneed an assbestw assessment to submVt WW this epo&abJon.
Description of work Replace %mace
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time AX, must list licensed electrician.
Subconbuctorst list Me cvmpanyname or Oty of Ft CoN/ns hcemr 0
Bedridan Plumber Mediankal H 122 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.
Print Applicant Shell Swanson ��j ® Glkm
Print Name: Y 5lgnatirre ll6 pace