HomeMy WebLinkAbout1344 Armsley Ct - Applications/Furnace - 10/03/2014P'sannitag, Deve;cVF`ner.i �. a ra:>s D."daUOn
i4i rJe 281 N. College Ave PA. Box 580
P '2- Moms fort Collins, CO 80524
��• tS Phone 970-416-2740 Fax 2246134
This application is to be used to apply for the following permits only (shack ail that apply)_ ❑ Air Conditioning
p Demolition (Interior non-structural) 0 Electrical Alteration (not change) ❑ Gas Lighter ❑ Gas Log
t service
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑Sewer Line ❑Photo -voltaic
❑ Ventilation ❑ dater Heater ❑ Water Line ❑ Wced/Peilet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all apAliea4il? i�rofittall9r. �ii site appdc"orz. incomplete applicetions miii not be accepts .
Application RBIA—I0—ID�
For office use only
job Site Address (required)
property owner Name i Address
s'] F30W>, 13y4 1aCMJGi
Applicant Name Address
5--1 90..x 1-.!>ti4 (-
Contactor Address
f c.D E .t tt if pfvc--J . 452- m
Contractor City of r't- Collins Sales Tax #
S11
lee5t�x mm"ber is regcired by BY 02nrea7�
Date
Value a. CanstrucFaorr
(labor, materials, profit) 7-1009
+ Co •,.. o
osas
mil-to-Zt'r- 9S3E
Zip
Phoneq�U
Gty/state
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City/State
Zip
Phone 0i'10
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City/State
Zip Phone
Are you paying taxes here or by report? ❑ Here ZReport
Are you paying with your trust account? 0 Yes ❑ No
Is this a residential or commercial project? ❑ Residential ❑ commercial y attached) Duplex
If residential, Is It: ❑ Single Family Detached ❑ Condo/townhome (single family
❑ Multifamily (apartment) ❑ Garage
if commercial, is it ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Matel L-t Medical office ❑ office 17 Retail
ClRestaurant ❑ other (explain) -tf
is this building so years of age or more? ElYes ❑ NO -YES, Youma%rneedtocontactHlstorcPresen
ng constructed?
If this ra 1975for a de im7l need anipeirnj'
t� what year Was the b
Ifprior asbestos ssessn�rt toil submit WIM Ors appricadom
, you
Description of work
-f lawn sprinkler/batloiow Pry
enter, must list licensed plumb.r. If firms time A/C, must list licensed electrician.
1
Subconaactors: List the company name OrGZyofRCalCnslicense=
PlumbFr�--- �manird
Rcerer Sher
pzGridan�—
I hereby acknowledge that I ha re read this applimtion and state that the above information is complete and correct I agree to
comply with all requirements contained herein and city ordinances and slate laws regulating building construction• i kiiOW'lllai a
permit is not valid until iv has been paid and issues,.
Applicant: Signature
print Mama:
Date
CA 90bl-£l9-OL6
ull000 V 6u1leeH 3N11 0321