HomeMy WebLinkAbout2430 W Stuart St - Applications/Furnace - 11/02/2015Nov 02 2015 09:04AM Gary Hooley Heat and Air 9702249198
page 3
City of
Fort C.olliris
Planning, Development Ili Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
OVER-THE-CQU NTER PERMITS 0 N LY
This application is to be used to apply for the following permits only (oheck.all that apply). D Air Conditioning
D Demolition (interior non-structural) O Electrical Alteration (not service change) O Gas Lighter 0 Gas Log
M Heating Unit ❑ Lawn Sprinkler D Mobile Home replacement D Roofing G Sewer Line C Photo -voltaic
D Ventilation C Water Heater D Water Line D Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable information on the application. Incomplete applicatfons will not be accepted.
Application # s 0 ' $mil Date �� ► j 'Z� i
For offlice oats or*
Job Site Address (Muked)
Value of Construction (labor, materials, profit)
2430 W. Stuart St.
$1,851.00
Property Owner Name Address
Cry/State Zip
Phone
My House Property'Servicil 1302 So. Shields St., A2-3
Fort Collins, CO 80521
689-8803
Applicant Name Address
City/State Zip
Phone
My House Property Servicil 1302 So. Shields St., A2-3
Fort Collins, CO $0521
689-8B03
Contractor Address
City/State ZIP
Phone
DS Shortride / Gary Hoole rl 1314 Webster Avenue
Fort Collins, CO 80524
493-3272
Contractor City of Ft Collins Sales Tax #
Are you paying taxes here or by report?
0 Here O Report
saks tax number is re4vledbyaffcondadivs
Are you paying with your trust account?
M Yes C No
34734
Is this a residential or commercial project? C Residential O Commercial
If residential, Is it; 0 Single Family Detached Q Condoltownhome (single family attached) G Duplex
0 Multifamily (apartment) 13 Garage
If commercial, is It: A Bank O Bar Ci Church 12 Hotel/Motel G Medical office G Oritee (3 Retail
D Restaurant 0 Other (explain)
Is this building 50 yams of age or more? ❑ Yes ONO If yes, you may need to contact Nlston'c Piwemalion
7 this is for a demolition permit, what year was the building constructed?
Ifpfior to 1975, you whIl need an asbeslos Lvmmwment to submit with this application.
Description of work Replace Furnace
*If lawn sprinklerlbackflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: l& the minpanynameorClyofFtCollins&-eense 0
Oectridan Plumber. Meftrilcal H-1654 Roofer
Other
I hereby acknowledge that I have read this applicatlon 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 inrow that a
permit is not valid until it has been paid and lssued.
Applicant Shelly Swanson
Print Name; Signetirre
Date ji ILZj-