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HomeMy WebLinkAbout6318 Cattail Ct - Applications/Furnace - 01/08/2016From 9702299983 1.970.229.9983 Fri ]an 8 15:41:22 2016 MST Page 1 of 3 FROM FAX NO. Jan. 08 2017 10:38PM P1/3 FCity of Or# Collins Planning, Development &Transportation 281 N. College Ave P.Q, 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) Q Gas lighter n Gas Log P"Heating Unit © Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic 4D Ventilation ❑ Water Heater 13 Water Line Q 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 -#:Si( Date f cp For oflice use only Job Site Address (required) Value of Construction (labor, materials, profit) 6318 CATTAIL CT _ Properly Owner Name Address City/State Zip Phone RICH PIPER 6318 CATTAIL CT, El'(' 070 991667 Applicant Name Address City/state zip _ Phone Contractor -_ Address City/State F-�Wt1irkCzip Phone ci''Ib y" C. `d) 1_5642 n_ CO 2_4 ;zama Contractor City of Ft. Collins Sales Tax # by Are you paying taxes here or by report? here Are you paying with your trust account? Cl Report ❑ No Sales tax numberrs requIrald all contractor; ,Yes Is this a residential or co mercial project? 4 Residential El Commercial If residential, is it: Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex Multifamily (apartment) ❑ Garage If commercial, is it: ❑ Bank ❑ Bar ❑ Church (3 Hotel/Motel ❑ Medical office ❑ Office ❑ Retail ❑ Restaurant ❑ Other (explain Is this building so years of age or more? IlYes No If yes, you may need to contact Hlstorlc preservation If this is for a demolition permit, what year was tfie building constructed? __.., ,_..... __...,.... ,,._._..____.—... . If prior to 1975, you will need an asbestos assessment to submit W0 this application. Description of work REPT A,CF FURNACE -- 95% *If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician. Subcontractors: List the company name or City of Ft Collins license # 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 ordinances and state laws regulating building construction. I know that a permit is not valid until it has been paid and issued. Applicant: Print Nam