HomeMy WebLinkAbout2826 Morgan Ct - Applications/Furnace - 10/18/2011FA
FAX NO. :9702299983 Oct. 18 2011 10:16AM P3/3
City o Planning, Development & Transportation
} 281 N. College Ave P.O. Box 580
FOIrl 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). ❑ 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 O Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line O Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer),
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application # i31109 20 °Z
For office use only
Date—,
lob Site Address (required)
Value of Construction (labor, materials,
profit)
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Property Owner Name
Address
City/State Zip
Phone
ZX
Applicant Name
Address
City/State ZIP
Phone
Contractor
Address
City/State Zip.
Phone ct 1b
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Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report? O Here
Report
Sales tax number4crequired by all contractors.
Are you paying with your trust account? %,Yes
❑ No
Is this a residential or commercial project? jrp
If residential, is it: Single Family Detached
❑ Multifamily (apartment)
If commercial, Is It: ❑ Bank ❑ Bar ❑ Church
sidential ❑ Commercial
❑ Condo/townhome (single family attached) ❑ Duplex
❑ Garage
❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes /No If yes, you may need to contact Historle Preservation
If this is for a demolition permit, what year waste building constructed?.,..,
If prior to 1975, you will need an asbestos assessment to submit with this application.
Description of work
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or City of Ft Collins license #
Electrcan �,.. 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:
Print Nam
Date-AHi--i