HomeMy WebLinkAbout3909 Ridgeway Ct - Applications/Furnace - 02/26/2015FROM :NCR
FAX NO. :9702299983 Feb. 26 2015 09:11AM P2/2
Fort Collins
Planning, Development 8& Transportation
281 N. College Ave P.O. Box 580
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
J� Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement 0 Roofing ❑ 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 # S 15012?5 Date
For ofte use only
Job Site Address (requlrted)
Value of Construction (labor, materials, profit)
Property Owner Name
Address
tte Zip
Phone
icitat
Applicant Name
Address
e Zip
Phone
Contractor
Address
City/State PV D(1IVcZip
Phone Of"M
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C. 21 IS
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Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report? Klere
❑ Report
Salestax number Isrequlredbyall contractors.
Are you paying with your trust account? es
❑ No
Is this a residential or commercial project? ® Residential 11 Commercial
If residential, is it: Q Single Family Detached ElCondo/townhome (single family attached) ❑ Duplex
b Multifamily (apartment) ❑ Garage
If commercial, is it: Cl Bank ❑ Bar ❑ Church Ia Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant 13 Other (explain)
Is this building s0 years of age or more? ❑ Yes No If yes, you mayneed to contact H/stor/c preservation
If this Is for a demolition permit, what year was a building constructed?
Irprlor to 197s, you will need an asbestos assessment to submit with this appllcatlon.
Description of work
0
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or C/ty of Ft Collins license Of
Electrician 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 dty 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 w'"t.