HomeMy WebLinkAbout2924 Eindborough Dr - Applications/Electrical - 07/13/201107/13/2012 16:34 FAX 9704161716 GLANZ ELECTRICAL 12 001/001
Fart Collins
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 97D-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 C] Sewer line ❑ Photo -voltaic
❑ 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 accepted.
Application # ' cq0 '1 Date July 13, 2012
For afte use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
2924 Eindborough Drive
$1,200
Property Owner Name
Address City/state Zip
Phone
Doug
2924 Eindborough Drive Fort Collins, CO 80525
970-297-8972 .
Applicant Name
Address City/State Zip
Phone
Contractor
Address City/State Zip
Phone
Glanz Electrical Contracting,Inc.
1713 Lincoln Ave. Al Fort Collins CO 60524
970-482-5218
Contractor City of R. Collins Sales Tax # 21494 Are you paying taxes here or by report?
❑ Hen: M Report
salegraxnuneertsrevwredbyall canrracrax Are you paying with your trust account?
❑ Yes W No
Is this a residential or commercial project? ® Residential ❑ Commercial
If residential, is it: ❑ Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
E3 Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes ❑ No Ifyes, you may need to contact Historic Preser✓abon
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 w/th this application.
Description of work Replace faulty 100 amp meter/main breaker panel.
*If lawn sprinkler/baddlow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List Usecvmpanyname orOlyoffsCollins 1 enSe#
SemidanPlumber Mechankal -.Roofer Other
I hereby acknowledge that I have read this application and state that the above information is complete and coned I agree to
comply with all requirements contained herein and city ordinances and state laws regulating building construction. I (know that a
permtt is not valid urktil it has been paid and Issued.
J
Applicant:
Print Name: Thomas I Glanz Signature Date_