HomeMy WebLinkAbout7406 Greenstone Trl - Applications/Furnace - 09/26/2014City of Planning, De4elopment lit Transportation
Fort(' "`s^�► p �^f 281 N. College Ave P.O. BOX 580
"�.roW s Fort Collins, CO 60524
Phone 970-416-2740 Fax 7.24-61.34
OVEIt-IRRE-COUNTED PIERMITS ONLY
This application is to be used to apply for the following permits only (check all that apply). U Air Conditioning
12 Demolition (interior non-stiiictural) CI Llectrical.Alteration (not service charicge) ❑ C•'mq Lighter ❑ Gas Log
❑ Healing Unit 0 Lawn Sprinider 0 Mobile I -tome replacement n Rooting ❑ Sewer Line ❑ Pl7oto-voltaic
Ll Ventilation C7 VViater i Icater ❑ VV.ater Line ❑ Wood/Pellet Stove (must be Et7A certified, provide: make, model and
mOnufacturer).
Complete all•apr,licable information on the application Incomplote applications will not be aceopted.
Application Date
Aor office Lcam on!k
]gb/Sit%eAdd�r,�ess��r�e^ry�u��•i?UJ / Value of Cotistruclibor, matRriair,, prof//)
o.
51-operLy Owner Nam Address Cit /State Zip Phone
AL[ �jpliiLcei�ntNanle Address CILy/State Zip µ Y�
Phone
Contractor t Address CiLy/State zip ^Y
f/ Phone
'� � � � �1_ �'�._± ,� ram—•
Contractor City of Ft: C011ins Sales Tax iR Are you paying taxes here or by reliort•? d Here
s,,/e t}xnumGe;,r,,:Nmr i�yaUc=};,r,ac'(w:a Are you p7yin) with your tru,l' eCCe(Int? El Y( 1r• i'1,
Is this a re•.sider±tial nr for nerrlaf proJect7 I siClent(aI ❑ Comlm irci,
If residential, is itc pelf( 1='t�mily Det��;,�ccl 0 Condo/t'ownhome (single famlly attached) ❑ quplex
MIII ifdnlily (apartment) ❑ Garage
If commercial, is IU C:i 10ank ❑ 3ar ❑ Church ❑ I-lotel/Motel ❑ Mcdical office ❑ offire ❑ Ret- I
❑ Restaurant 12 Other (explain) _
is this building 50 years of age or more? ❑ Yes O No Iryr�c, you n7ayhee7lo rnhl3ct Hrstarri P/t?s�Ptatioq If this is for a dertiolition permit•, what year was the building constructed? _
lPprlo,• to 19X9, you rail/ n^eo ai, dsfiestas aSarssrry7C1,t to suG,p/t Iv/b} t!,/s appllcc7f/017• "---
Description, of work.
❑ Report
❑ No
*If lawn sprinIftr/backflow prr_venter, must lia licensed plumber- If first; tln±e A/C, Inusl: list liccns',4d eiectrirran.
Subcontractors; l rs the r±,• D4, or'rt Ct}d/ns /icc�nse, •'�
r;
GIE'Ci17Cliln. 'IWtlI}CI', ,. �" Ff.''•''�
•^---' .._.�__....., .----- M.Jiunical /,f .._ .: .... lururer Ol'Izel'
I hereby acknowledrr ghat l h. ,e rend this appiicalion and stale that tile above information is enr,:!P!.
comply with all requilettleni_ cuntalned hta'eln and city ordinances and stale laws regulating buil01:'%1 co intro l0h. I IWowttt<i4'a
perltvt is not'valip until. it Nus /seen paid and iasued.
Applicant, i•- .: ...•, .
Print; Name,.