HomeMy WebLinkAbout2224 Smallwood Dr - Applications/Furnace - 04/15/2015Apr 16 1507:07a Swan Heating and Air
970-613-0826 p,1
of
Flirt Collins
OVER-THE-COU
This application is to be used to apply for the follow
II D olition (interior non-structural) ❑ Electrical Alter
Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home rer
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ woo(
manufacturer).
Complete all applicable information on the applicat
8150 30'�I3--Fvrna Ck_ -
Application # 3 � S' l r
for oliice use only
Job Site Address (requkwa
Property Owner Name Address
Applicant Name Address
Contractor 1 Address
:)WCLYl
Contractor City of F. Colllns Sales Tax #
Safes am number is required by all CwftadOm
is this a residential or con rcial project? bl Resioe
If residential, is it: U Single Family Detached ❑ (
❑ Multifamily (apartment) ❑ (
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ i
❑ Restaurant ❑ other (expla
is this building 50 years of age or more? ❑ Yes S
If this is for a demorition permit, what year was the
Irpnor to 1975, you will need an asbestos assessment
Description of work
*If lawn sprinkler/backilow preventer, must list licensed
Subcontractors List the company name or Py of Ft C
Electridan Plumber
I hereby acknowledge that I have read this application and
comply with all requirements contained herein and city ordi
Permit is not valid until it has been paid and Issued.
Applicant: ' r l(h r `
Print Name: d
Planning, Development&Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
:R PERMITS ONLY
permits only (check all that appiy). Air Conditioning
i (not service change) ❑ Gas Lighter ❑ Gas Log
ment ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
let Stove (must be EPA certified, provide make, model and
Incomplete applications will not be accepted.
Date H ' i 5- )
Value of construction ;abo mat>�als, profit) O
1 SU G l//VV__
City/StateZp —> Phone . -7 C�
r Et. l f3 ka s M 060 52 % 029
City/State Zip Phone
City/State Zip Phone q-7 U
1-DvelcLn.(i Co 8(�9 215-5 —7�
TAre you paying taxes here or by report? ❑ Here ❑Report
Are you paying with your trust account? ❑ Yes ❑ No
❑ Commercial
ownhome (single family attached) ❑ Duplex
❑ Medical office ❑ Office ❑ Retail
If yes, you may need to contact Historic Preservation
ig constructed?
5mit with this app&Rdon.
If first-time A/C, must list Incensed electrician.
license #
Roofer Other
that the above information is complete and correct. I agree to
s and state laws regulating building construction. I know that a
Date
r)