HomeMy WebLinkAbout6416 Solar Ct - Applications/Furnace - 12/22/2015I L I Tra ns,_
Pinnning, Development L J -DrtF. d o n
2 1 - g I
81 N. Colloe Ave P.O. Box 58G
Fort Collins, CID C 80524
r. r1hoine 970-4,'6-'7-10 Fa.;, 2 -1 - 3
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71 . .....
A u5h�9�'iny wit
M il,�
Iij -�:lNion is to be LIS'd to apply "Or the 4011OVVIng Pe 1'LS
Only (check all thal apply). 0 A'i"Card '"oni
'le -ige' G@ Lo..
no:j_q�n_!Miral' EJI F -drical Altarotion [not service coal 01 Gas Lighte! 0 as I
U,iir E, LvMn S,DininMer D. Mobil- Horno replacement 0 Roofing 0 Sa%mer Line Di Photo-vollc'.:'
L -1 olatei Heatar 0 Wat.ar Line 0 Wood/Pellet Stove (must be EPA certified, provide rnall--. mod-=1
all,
appi'oable MjO.,Ir:itiojl On File app.'icatjon. lncomPle'M aPPlic2t10ns Will not be accaptacj-
g
;r
Date
r ,-.r �'
;%J-jI'ZValue of Const--_ict".on (labor, ma.er,ils, pof"Li
9S (�&-WHIL?I_P
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Address
City/State
Zip Rion, -
Naine_
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A 'dr.
c ss
city/S'aata
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A13CH"Iss
L
LI Flern r,-( R-
.. ..... aN I; -ere or by report
;'i I C]"Tol- CiLy "r Collins Sa!es I Are yoi I paying Mixes I !
C,1170aAre you paying with your trust �ICCMI-jt? f'yes L"
or crimmarcial 1)(Ijedt? Detached
ID Cornmercla' e r" 'I El lupkax
it cask;: filial, is ji�: Ingle Family Detached 0 Condo/Wimriname (single family attached)
171 Iviijitifninibf (apartment) El Garage
El Bank 0 Bar Fj ChUrCh El 17101ZE-1/1"1017CI El Medical office F21 Office 0 lk�-tail
0 Res'auiant Fi Other (explain)
t;,;j.j;j:irJjj'� SD years 0"age orinoire? o yes Li NO if ye5 you may need !'D contlcf
tr th;' is a perm.;t, what year was the building constructed? wfflneadan a5L1es,osa55a55mcr'tI0 vbmIt witl7 thisap, tl"0[7.
% livcit
_ZkMCAL —I
;17 pr_,vL!'.(:er, fiILSL list- licensed plumber. IF fl,st-timeA/C, MUSt list licensed elactridari.
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"Ige 0,2.! 1 have tljj�,' aj)l)liC�ILjOPj -Ind stab: that the above inl7ci-mation is corripIcte laic: mr-U. 1 agre-'a M
E-.11 reqfir�tmeri(s c0iiiEline-d h1ereir. and 'city ordinances and state lDws regulating building consl:ruction. I knoliv thnit -11
is 1101: V-211i'l UrItil it has been paid and issued.
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