HomeMy WebLinkAbout1550 Blue Spruce Dr - Applications/Water Heater - 06/25/2015Jun 251501:28p Hahn plumbing
970-493-5325 p.1
FCiof
lirt Collins
Planning, Development & 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). ❑ Air Conditioning
0 Demol'dion (interior non-structural) 0 Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
0 Heating Unit 0 Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing (3 Sewer Line .13 Photo -voltaic
❑ Ventilation ` Water Heater 0 Water Line ❑ Wood/Pallet Stove (must be EPA certified, provide make, model and
manuiwureO
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application # -F-;)l 450 I��1. Date j.
For a ce use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
3
Property Owner Name
Address
C1ty/State Tip Phone "
' r
2,` o r
o tuceA- 0c2
Applican Name
Address
Clty/State Zip Phone
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Contractor j
Address
Citylstate Zip Phone
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Contractor City of Ft. Collins S46
lax # T?'1P- /5-
Are you paying taxes here or by report? ❑ Here IgReport
Sales iaxnumber laregL&'edbyaYcw&cxW=
Are you paying with your trust account? )(Yes 0 Nb
Is this a residential or commercial project? ❑ Residential MCommerdal
If residential, is It: ❑ Single Family Detached 0 CondolfoWnhome (single family attached) • 0 Duplex
Multifamily (apartment) ❑ Garage
If commercial, is it: ank 0 Bar 0 Church ❑ Hotel/Motel ❑ Medical office ❑ Office 0 Retail
0 Restaurant Cl Other (explain)
Is this building 5o years of age or more? ❑ Yes ❑ No If yes, you mayneed to contaci•hlisto&Pmservabon
If this is for a demofitfon permit, what year was the building consbiKbed?
Ir prfor to 1975,. you will need an asbestos assessment to submit with this BXRcafion.
of work
- - - ., - i IiEgyL —hlc- ISSWE
*IF lawn sprinkler/backfiow preventer, must list llce4ed plumber. Ffirst-time AIC, must list licensed electrlclan.
Subcontractors: L& the companyname or City ofFt Collins&cense #
Electrician plumber. Medtanlcal Roofer Other
.
I hereby acknowiedge 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.
Print Name' iA(d JC h Ae till Sig
= Date '
Jun 2515 01:28p Hahn plumbing 970-493-5325 p.3
Fort Collins
Community Development & Neighborhood'Services
261 North College Avenue
Foci Collins, CO 60524
970.4162740
over the counter oermit info sheet for;
New and reviacement hvac roQEM equipment, furnaces, and water
heaters
The following information must be included to approve the permit. Check all that apply.
1. Roof -top equipment and furnaces:
❑ Replacement of existing equipment.
❑ New/additional roof -top equipment.
❑ Equipment is the same weight or lighter and similar or smaller size/footprint.
❑ Equipment is heavier and will provide engineered documentation showing roof can
support new equipment or modifications that must be done to support such
equipment
❑ Replacement equipment is in the same location and not taller than previous.
❑ Replacement equipment is in new location and/or taller.
❑ For New equipment. See attached engineered documentation showing roof can
support new equipment or modifications that must be done to support such
equipment.
❑ Ground or floor mounted.
2. Hot Water Heater:
Replacement
❑ New
Ai Same size or smaller than previous.
❑ Larger than previous water heater.
❑ If for a restaurant I have approval from Larimer County Health Dept for minimum
water heater capacity.
3. All equipment/appliances must be installed in compliance with 2009 IMC, IFGC, IPC, and
2011 NEC.
i I' �
Applicant si ture and d
(Form updated 1-18-2013)