HomeMy WebLinkAbout7020 Avondale Rd - Applications/Mechanical - 04/18/2012—� 04/18/2012 13:28 9702329739
city of
Planning, Development rl Transportation
281 N. College Ave P.O. Box M
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
PAGE 03/03
OVER-THE-COUNTER PERMITS ONLY
This application is to be used to apply for the following permits only (check all that appty).);�Ar Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) 0 Gas Lighter ❑ vas Log
sting Unit 0 Lawn Sprinkler ❑ Mobile Home replacement D Roofing 0 Sewer Line O Photo -voltaic
0 ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Peilet Stove (must be EPA certified, provide make, model and
manufacturer). ted
Complete all applicable information on the application.
Application #�,�
Fnr nlRrp izan nniv
Incomplete applications will not be 0c 10
Date , tI L' C5O •00
Is this a residential or rdal project?residential O Commercial D Duplex
If residential, is it: ngle family Detached ❑ Condo/townhome (single family attached)
D Multifamily (apartment) 0 Garage
If commercial, is it: D Bank O Bar ❑ Church 0 HoteUMotel D Medical Offlce ❑Office O Retail
0 Restaurant ❑ Other (explain)
Is this building So Years of age or more? O Yes ONO If yes, you may need to contact Historic P�rrvddon
if this is for a demoliitlen permit, what year was the building constructed?
If prwr to 1975, you w 1l need an asbes7os assessment to submit with this aPP/ication.
Description of work
*If lawn sprinWa/baddlow preventer, must list licensed plumber_ If first-time A/C, must list licensed electrician.
SubppnblactO s; lAt the company name or city of Ff Collins license #
Elecvrdan—
Plumber MechantCal_ Roofer Other
I hereby 8&jw ledge that I have read this applicati OY and state that the above information is complete and correct. k� � a
comply with all requirements contained herein and city ordinances and state laws regulating building coo
permit Is not valid until it has been paid and issued.
Appficante 4 Date f "
print Name: GP_ . _—,__.-..__.__signature.. T_^- •_--�