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HomeMy WebLinkAbout633 Stover St - Applications/Air Conditioner - 04/05/2012City of Planning, Development & Transportation r 281 N. College Ave P.O. Box S8o t+Forl 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 the following permits only (check all that apply). 0 Air Conditioning ❑ Demolition (interior non-structural) 13 Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log 0 Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing III Sewer tine O photo -voltaic EI 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 accept d. Application # I a ,-), For � use only Date Is this a residential or commercial project? 13 Residential ❑ Commercial If residential, is It: E3 Single Family Detached O Condo/townhome (single family attached) CI Duplex ❑ Multifamily (apartment) ❑ Garage If commercial, is It: ❑ Bank 13 Bar A Church ❑ Hotel/Motel ❑ Medical office ❑ Office IO Retail © Restaurant 13 Other (explain) Is this building 5o years of age or more? ❑ yes d No DFyM yuynW1hwdLpc0"&ai& py ,yy If this is for a demolition permit, what year was the building constructed? Ifp►ia'M,i97� yauwlt7r�eedana�ie�t>'s�mne»cr�r.szptlr7ndfhda's�gvdfC�(idrf. Description of work *If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electHcian. Subcontractors:[istdaercprtparry,�amea[�y,pf}�,�p Electricianfllt_�� { Plumber Medhanioaljt(L� Roorer 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 construCtlon. I know that a Permit is not valid until it has been paid and issued. Applicant: Print Name: Date