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HomeMy WebLinkAbout2502 Dallas Creek Ct - Applications/Water Heater - 08/27/2014at-v of Collins Planning, Development & Traa sporUtIon 283 N. College Ave. P,0, ;lox 560 Fort Collins, CO SOS24 Phone 970-41.6-2740 Fax 224-6134 'y p s 5 g Thtr application is to be used io apoly for.the fo€lowing permits only (check all that apply). Q Air Conditioning ❑ Demolition (interior non-structural) L; Wiectrical Alteration (not service'c:range) 7 Gas Lighter 0 Gas Log, G Heating Unit ❑ Lawn Sprinkler ! i N obite Home replacement G Roafing ❑ Seiner tine 0 Photo -voltaic 0 Ventilation ,2''Water Heater Q L4later Line 0 l''Nood!Pellet Stove (trust be EPA certified, provide make, model and manufacturer). Complete all applicable Information oh the application. Incomplete applications will not be accepted. Application ® Date �_ r��. � 4 For of ke msr only Job.Site Address ;reau{rarJ� — Value of Construction (labor, materials, profit) Proper..ty Owner Name Address oty/State Zip Phone 9';'� r t "Bii {,.%u'r'_4_ Applicant (Name Address City/State Zip phone Contractor— 7 Address 3 r E 3 .+i.-.. )Ai ,° •C.`'�..F�^ 7 `G.._: :•1.? ' 3r '..'% - City/State --_- Zip Ph r. ere i�i't' 3&.i'' ^�%d�L�i a't'/t.. M-.:f?`,.• L.,r� OJ rz ` fi E.� Contractor City of Ft:. Collins Sales Ti #' Are you paying taxes here or by report? P,41ere 0 Report Saks �x nvm&rls required bya# cont.•acF.� s. Are you paying with your trust account? l7.Yes Ct No t i is this a residential or conTmerdal project? ,-16siden6al 0 Commerciai — rf residential, is It-, .�ingie Faraily Detached 0 Condo/townhurie (sinaie family attached) 0 Duplex 0 Multifamily (apartment) 0 Garage If comnierciat, is it: Cl Lank 11 Bar © Church Q Hotel/Motel 0 Medical office 0 Office 0 Retail E3 Restaurant © Other (explain) _-- _—•-------_-- — 1 Is this building 50 years of age or more? Ci Yes' 0 No Jfyes, You nz�a ,?c�n'fc rertactHis orie P.�e�rarabor i If this Is for a demolition permit, what year was the building constructed? ifpr,%or to 1.975 you will rneed an a &e Stos assessment to.sw5mlt wth tlrr app{icat{nn, 7escritordon of work ! `, y),-1 IA e s: Dom) &L ijc If lawn sarinklerlbackilow preventer, must list licensed plumber, If first-time A;C,, must list licensed electrician. i Subcontractors: Lv-t the company name nr city of Ft 601,,ms An my # Electrician Plumbel:_,rr Pledtanical- ___ Roofer ;tier I hereby acknowledge that I have read this application and .state'that the above Information is uarnptete and correct. I agree to comply with ail requirements rnhtained herein and city ordinances and state laws regulating huilding construction. i know that a i permit is not valid until it has been paid and issued. tLi=pE3cant: , t ! �� SSiganature v i i 3 ar ` Date f. T Jo T abed 1SW 1SW Wd TS:9T:£0 bTOZ 6nV LZ pam stu—Ess C£00 uao.aj