HomeMy WebLinkAbout4407 San Remo Cir - Applications/Water Heater - 09/23/2015Sep 231512:59p Hahn plumbing
970-493-5325 p.1
City oT
Collins
planningi Development 8LTransportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970_416-2740 Fax 224 6134
O ER—T I Fw'v®'JIt'� � ci" k` l� at ONLY
Air Conditioning
This application is to be used to apply for the following permits only ( Gas Lighter ❑ Gas Log
Sewer Line _ dPhoto-voltaic
❑ Demolition (interior non-structural) !? Electrical Alteration (not service change provide make, model and
CI He Unit ❑Lawn Sprinkler ❑Mobile Home replacement ❑Roofing
Ventilation 0 La n,teeter ❑ �Nater Lane o WcodiPellet Stove (must be EPA certified, p
manufacturer).
Complete all applicable information on the application. incomplete applications will not be accepted,
V�?� i
Dale
Application # N Fbr c only
Value of Construction (labor, materials, profit)
lob Site Addres ;required) r
I p t%i Zip t Phone
Address City/Ste ^ y
Proper Owner Name f (] f
S� rf Citylstate Zip Phone
Applicant Name Address
J l ' c77
City/State Zip Phone
Contractor Address
axes here or by report? ❑Here l (Report
Contractor City of Ft. Collins S s Tax mP- / S Are you paying,Are you paying taxes
itb your trust account? Yes O No
Saris rax rumberlsrdquned by all contiactors.
Is i nis a residential or c mercW project? Resir]enUol ❑Commercial
If residential, Wit. ingle 1 amlly Detached 1? Cando/townhome (single family attached) Cl DuPlox
10 Multifamily (apartment) 0 Garage
If cornmercial, is it: ❑ Bank [I Bar O Church ❑ Hotel/Motel ❑ Medical Office ❑ Off"
C1 Retail
❑ Restaurant ❑ Other (explain)
Is this building Be years of age or more? ❑ Yes ❑ No If yes, you mayneed to contacr}fistoric PrnseNation
Ii this rs for a demolition permit, what year was the building constructed?
Ira prior to i92S, } ou will need an asbestos arsat:srnent to sub mft with this app#cation.
or work
*If lawn sprinkler/backflow preventer, must lie` licensed plumber. If first-time A/C, must list 11censed electridam
Subcontractors: u5t chu comparrynameorCiiyofFtCo111ns1ic nse #
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 ordinancesand state laws regulating bulloing COn5trUCuOn. i know that a
permit is not valid until it has been paid and issued.
Applicant:
Print Nam