HomeMy WebLinkAbout2960 W Stuart St - Applications/Furnace - 11/05/2015Nov 05 2015 10:57AM Gary Hooley Heat and Air 9702249198
page 2
Fort Collins
1111'�
Planning, Development & Transportation
281 iV. 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). D Air Conditioning
t7 Demolition (Interior non-structural) O Electrical Alteration (not service change) D Gas Lighter O Gas Log
O Heating Unit G Lawn Sprinkler C Moblile Home replacement G Roofing G Sewer Line O Photo -voltaic
O Ventilation 17 Water Heater C3 Water line O Wcod/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 # Ezl /i . pate 11/5/2015
For ofte Lw only
Job SltSe Address (ragalred)
Value of Construction (labor, materials, profit)
2960 W. Stuart Drive #D108
$1,806.00
Property Owner Name Address
City/State Zip
Phone
Lyn Karius 837 Pear Street
Fort Collins, CO 80521
219-9924
Applicant Name Address
Clty/State Zip
Phone
Lyn Karius 837 Pear Street
Fort Collins, CO 80521
219-9924
Contractor Address
CItW/State . Zip
Phone
DS Shortride / Gary Hool®lb 1314 Webster Avenue
Fort Collins, CO 80524
493-3272
Contractor City of FL Collins Sales Tax #
Are you paying taxes here or by report?
M Here C Report
Siktstax nuwft rxsrewmwpvalrcommaws.
Are you paying with your trust account?
M Yes O No
34734
Is this a residential or commercial project? 0 Residential 13 Commercial
If residential, is It: M Single Family Detached A Condo/townhome (single famEy attached) ® Duplex
10 Multifaamlly (apartment) 13 Garage
If commercial, Is it: 13 Bank ® Bar 13 Church la Hotel/Motel G Medical office G Office 0 Retail
. ❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes ❑ No 1J`^ you may need to intact HlstoricPhreservatfon
If this is for a deniolitlon permit; what year Was the building constructed?
lfprior to 1975, ynu will need an ashestos assessment to submit mM this appllcaffon.
Description of work Replace Furriace
*If lawn sprinkler/backflow'preventer, must list licensed plumber. If first-time NC, must list licensed electrician.
Subcontractors: List the campany name or City of Ft Collins license f
Electrician Plumber- Mechanical H-1654 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 regulatlng .building construction I know that a
permit is not valid until it has been paid and Issued.
Applteart Shell Swanson
Print Name: y Signature