HomeMy WebLinkAbout1223 Kirkwood Dr - Applications/Furnace - 11/25/2014Nov 25 2014 01:34PM Gary Hooley Heat and. Air 9702249198
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Fotrt Collins
Planning, I?evelopment St 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). O Air Conditioning
❑ Demolition (interior non -structure[) G Electrical Alteration (not service change) D Gas Lighter 0 Gas Log
M Heating Unit D Lawn Sprinkler 0 Mobile Home replacement D Roofing G Sewer Line C3 Photo -voltaic
D Ventilation ❑ Water Heater E3 Water Line O Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacttuer).
Complete all applicable Information on the application. Incomplete applications will not be accepted.
Application # TA 2g15 pate 11/25/2014
For office use only
Job Site Address (rerlalred)
Value of Construction (labor, materials, profit)
1223 Kirkwood Drive
$1,834.00
Property Owner Name Address
City/State Zip
Phone
Kathy Hixon 1410 So. Summit View Dr.
Fort Collins, CO 80525
215-6559
Applicant Name Address
City/State Zip
Phone
Kathy Hixon 1410 So. Summit View Dr.
Fort Collins, CO 80525
215-6659
Contractor Address
City/State Zip
Phone
DS Shortridge I Gary Hoolli 1314 Webster Avenue
Fort Collins, CO 80524
493-3272
Contractor City of Ft Collins Sales Tax #
Are you paying taxes here or by report?
0 Here Cl Report
.sales axrwnaarrrsregcdradbyaacnntrddcxe.
Are you paying with your trust account?
D Yes Cl No
34734
Is this a residential or commercial project? M Residential 17 Commercial
If residential, is it: 0 Single Family Detached 12 Condo/townhome (single family attached) 13 Duplex
0 Multifamily (apartment) 17 Garage
If commercial, Is it: 0 Bank D Bar O Church ® motel/motel 17 Medical office G Office 0 Retell
0 Restaurant D Other (explain)
Is this building 50 years of age or more? ❑ Yes LINO Ifyes, you may need to contact Ml rlcPresetwtlon
If this is for a demolition permit, what year was the building constructed?
Ifprror to 1975, you wNl need an asbestas assessment to submit w/th this app#a tJon.
Descrlpdon of work Replace furnace
lawn smftlerlbackflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: Ust the company name or Gty of Ft Ca(lllw llcense #
Bec rldan plumber Mechanical H-1654 Roofer Other
I hereby acknowledge that have read this application and state that the above Information Is complete and correct I agree to
comply with all requirements contained herein and city ordinances and staff laws regulating building construction. I know that a
permit is not valid until It has been paid and Issued.
Applicant; Shelly Swanson
Print Name: Signature ��Yr jd 1/i ���Y(. pate 11126114