HomeMy WebLinkAbout3006 Rustic Ct - Applications/Furnace - 05/26/2015c'i'tyai' • Plenning, Developmelil' Transpprtatipn
9r^�^r~a a^^^► p �t c 20-1 N. College Ave P.O, 13ox St30
F & .C.011:1'N'�+ Fort Collins, CO 00521
Phone 970-<116-2740 Fax 2211,613:
v9p-TOE-COUNTER PERMIT. ONLY
This :•1pp11C,10011•1$ LO be L(54(1 t0'dI)r)jy fpr the f0IlOWlrlg pL•rI111tG Ohly (ChUC14 all thak apply), rl All' CQltditiOnllld
❑• rh 1110111ion (interior rion-stn.u,turat). ri Llech'icaLAltcr ttipn (not sellri111 change) II h-M I_Igly). I-! r C l_ati
1;,1 I Icntinrl lJnifi 0 I_rtvvii Sprinkler 0 Mobile Homo rerllacerrent. 17 Roofing C.I Sewer I„ Ilo 1-1 lshota•vQItaic
0 vrntfiaticn ID W"Mel. hic.ater • fl Wntcr l.,ine L'] WO(KI/ 01let Stove (must be EPA crarfirirc!„prpvidp i'n71ce, mociel and
Comhleln all icable, irlforntation oil the apUiication. incolalplele applications will not ba tacconted.
Applicc.1don /'` I Pqze I�iaCe
r-n7•ofto rett Crr7rr -- --
Sob Site Address (ratqui7>^rf) - Value of Construction (labor, nvltrarrllr;, prolil) —�
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Pl-operly Owner- N rrlc Address. Clry/stele 71p . —Phone
IRzffic
Applicant Nnnio Aciclress City/State �lu�te
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�I�/f7 C f.(� �lil� l/'>'� r" � /ti I
Contractor : AclrJress '
'�t '•� ��- Cily/S lel.E 7�L Phone�
CotlUacl;or City, a(' fL..Colli11.5 ` alc,'1ax ll. • At you paying) taxea Tigre or by report? Cl I•lore ra I�cport
Srrrelrtra nrarrliryrsw gt�irrc�Grallrx,grr)cfur.;, Are YOU paying wIL11 your trust' Itcrni.inl? CI yo f_l No
Is this a residenel.11 or c(li nnlercllll proje•CL? ,1t KfResfdcnlial ❑ ConirnercialIf .cmidrillfal, is it
• yinyle R1111ily Dctat hed I:] Condo/townlloinc (single Family ett'ec11e(i) [)uplex
S, lifamily (al:)arlment) 0 &r.190 .
IF cnnlnl( rci]I, Is it: '(*_� r3unl: CI Bar rl C11L11 CI Hotel/Motel GI Mr:dfcai offir_c C7 Office Cl Iteh11
rJ Reslraurant 0 OLhmr (explain) ; _
Is this huildlnn �o•yeatas l)P eye or n1o��? L Yc's Cl Na TF — — --
I'F this Is For a cfr rtfolitiprf prarntlt, wllet year was the building onst �crl cl� r)eQd to cUhi�ct iyr'slorh l7i�;�sel] cation
ll'praorlo.t�9i5;1�1�i1�4i//ncelY<�7p<7�s'be�slns�7ss�ssrrrcphtosuGr)7iNlyiChFfFisepe7/ircrtiorl., ~ ~J---••"--"---
pe;Tr_rlption of wol'Ic
self fawn ;prinWar/Imcuiow prevrnter"1110st list" licensed plumber. If first' lime A/C, Inusl list �lehn,hd etecLrlelan`�-- --�
SuhtnntraClaat'a:l:c(CL7n•�rvry/kpn) rr7g7eor(Ytrorn-Dg/g./iiC/1.S�a,If -
�IeCtr9cian
I hr;.reby ttcknowleclgra that I have rearl this applical'ler n and state: thy at the above information is ton1171r kc ar'lrl colTeCh. I
ccmply With all :ctgliirgnihnts tgnhalned h(r Iti and city orclinances and state laws regulating btlildt, a Cusl,(10 C T . know t'ira{'a
pLrntil is 11�I;'valirl rulGil. it 11as I7 1211 pklicl 111d k1sued.
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t'intlanl'r let Coin 1
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