HomeMy WebLinkAbout2307 Sunleaf Ct - Applications/Furnace - 07/20/2015FROM :NCR
FAX NO. :9702299983 Jul. 20 2015 03:15PM P2/3
Fort CCorlhns
1�1 �` -
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 Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement M Roofing ❑ Sewer Line ❑ Photo -voltaic
l7 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 # 1 50 S4SG1 Date
For office use only
lob Site Address (Mulred)
Value of Construction (labor, materials, profit)
2 ..
Property Owner Na a
Address
City/State Zip
Phone
Applicant Name
Address"City/State
Zip
Phone
Contractor
Address
City/State P}Wll;kzlp
Phone Ql>jb
Not�-�h ✓ ( r
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Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report? ere
Oes
❑ Report
Sales tax number isrequired byall contractors.
Are you paying with your trust account?
1:7 No
Is this a residential or commercial project? rd Residential ❑ Commercial
If residential, is it: j/7Single Famlly Detached ❑ Condo/townhome (single family attached) ❑ Duplex
e Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Mote! ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other(eFebuilding
)
Is this building 50 years of age or more? ❑ Yeso If yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was k constructed?
if prior to 1975, you will need an asbestos assessment to submit with this applicatian.
Description of work
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or City of Ft Collins license #
Electrician Plumber 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.
Applicant:
Print Nam
Date M�'