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HomeMy WebLinkAbout1118 Deercroft Ct - Applications/Furnace - 06/03/2015FROM :NCA FAX NO. :9702299993 May. 26 2015 03:13PM PI/4 F©rt Collins Planning, Development & Transportation 281 N. College Ave P.O. Box 580 Fort Collins, CO 80524 Phone 970-416-2740 Fax 224-6134 OVERWTH&COUNTER PERMITS ONLY This application is to be used to apply for the following permits only (check all that apply). ❑ Air Conditioning ❑ )emolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas lighter M Gas Log Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ 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 # b 1 I Date For office use only lob Site Address (required) Value of Construction (labor, materials, profit) r✓ , wner Name Pr=.AY-Jutt.. r Address City/State Zip Phone Applicant Nailhe Address City/State Zip Phone Contractor Nor+ m' do Lc Address City/State F+Ulli;lCzip uac. Rt Zs co 9m 2.4 Phone 01'ib an Contractor City of Ft. Collins Sales Tax # Sales tax nunOwIIsrreequircdbyaiicontradom `06 l p e1Q Are you paying taxes here or by report? _Klere Are you paying with your trust account? fifes ❑ Report ❑ No Is this a residential or co mercial project? RrResidential ❑ Commercial If residential, is It: PSingle Family Detached ❑ Condoltownhome (single family attached) 0 Duplex ❑ Multifamily (apartment) ❑ Garage If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ office ❑ Retail ❑ Restaurant ❑ Other (explain) Is this building 50 years of age or more? O Yes �oo If yest you may need to contact Historic Preservation If this is for a demolition permit, what year was the building constructed? If pr/or to 1975, you will need an asbestos assessment to submit with this application. Description of work *If lawn sprinkler/backfiow preventer, must list licensed plumber. If first-time A/c, must list licensed electrician. Subcontractors: List the company name or aiy of Ft Coffins license 0 Electrician Phimher 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 city ordinances and state laws regulating building construction. I know that a permit is not valid until It has been paid and issued. Applicanti Print Nam Date SLe�t 5