HomeMy WebLinkAbout2641 Avocet Rd - Applications/Air Conditioner - 06/25/2015Jun 251501:26p Swan Heating and Air
970-613-0826 p.4
Fort Collins
OVER-THE-COU
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970416-2740 Fax 224-6134
PERMITS ONLY
This application is to be used to apply for the follow g permits only (check all that apply). ❑ Air Conditioning
❑ Demolition (interior non-structural) 0 Electrical Alte on (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Healing Unit ❑ Lawn Sprinkler ❑ Mobile Home repl acement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood ellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable information on the applicat
Application # B I SOL) 2 -7 Id
For office use only
Incomplete applications will not be accepted.
Date�A -\)5
Job Site Address (required)
Value of Construction (labor, materials, profit)
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Property Owner Name
Address
City/State Zip
Phone
Applicant Name
Address i
City/State Zip
Phone
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Contractor
Address
City/State Zip
Phone
Contractor City of Ft. Collins Sai x #
Are you paying taxes here or by report?
❑ Here ❑ Report
Sales tax number isrequfredbyall contradors:
a you paying with your trust account?
❑ Yes ❑ No
Is this a residential or commercial project? 9?Pesident
If residential, is it: mingle Family Detached ❑ Co
❑ Multifamily (apartment) ❑ Ga
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Ho'
❑ Restaurant ❑ Other (explain
Is this building SG years of age or more? ❑ Yes V_�
If this is for a demolition permit, what year was the bu
Ifpnorto 1975, you wi//need an, asbas(ns assessment to
Description of work
*If lawn sprinkler/backffow preventer, must list licensed plum)
Subcontractors: List Me company name orCty ofHCollins
Electrician Plumber Med
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:
Print Narn,
❑ Commercial
ownhome (single family attached) ❑ Duplex
❑ Medical office ❑ Office ❑ Retail
If yes, you may need to contact Historic Preservation
ig constructed?
unit Willi this aPPliration.
If first-time A/C, must list licensed electrician.
se #
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. LG -`,
4