HomeMy WebLinkAbout706 W Oak St - Applications/Furnace - 10/16/2015OCT-16-2015 01:1512M FROM -
9704048354 T-570 P.001/002 F-200
For t 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
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ 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 I lain 601� Date
For office use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
$3,174
Property Owner Name Address
City/State Zip
Phone
Lisa pitat 706 W.Oakr
t. Ft.C- ins CO 80521
970 22-081
Applicant Name Address
City/State Zip
Phone
Fort Collin-, Fleeting and AiK '�OR Commerce
Dr. #4 'Fort Coiling. Co 5
Contractor Address
City/State Zip
Phone
Fort Collins Heating and Air 208 Commerce
Dr. #4 Fort Collins Co 80524
970 484-4552
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
❑ Here ❑ Report
UestarnwnberIsrequired byallwnaacrvs:
Are you paying with your trust account?
❑ Yes ❑ No
Is this a residential or commercial project? 11. Residential ❑ Commercial
If residential, is it: of Ingle Family Detached ❑ Condo/townhome (single family attached) ❑ 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? ❑ Yes ❑ No Yyes, you may need to contact Histnr/cpreservation
If this is for a demolition permit, what year was the building constructed?
If prior to 1975, you WA/ need an asbestos assessment to submit with this application.
Description of work furnace install
*If lawn sprinlder/backnow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: L/.st the company name or aty of ft Coll/rrs license #
Bect idan Piumber 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,
ApliCarrt: I V r141 Date 10/16/2015
PrinnSig
t Name: Angela Morrow nature