HomeMy WebLinkAbout3034 Clemma Ct - Applications/Furnace - 01/08/2016Jan 08 2016 12:47PM Gary Hooley Heat and Air 9702249198
page 3
Fort Collins
Planning, Development & Transportation
281 N. Coilege'Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
OVER-THE-COUNTER PERM17S ONLY
This application Is to be used to apply for the following permits only (Check -all that apply). D Air Conditioning
G Demolition (interior non-structurao O Electrical Alteration (not seNEce change) G Gas Lighter 0 Gas Log
0 Heating Unit O Lawn Sprinkler C3 Mobile Home replacement D Roofing Q Sewer Line 0 Photo -voltaic
❑ Ventilation O Water Heater 0 Water Line O Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable Information on the application. Incomplete applications will not be accented.
Application # ( t'oo l C)b
For oxce use only
Date 118/16
Is this a residential or commercial project? m Residential G Commercial
If residential, is it ® Single Family Detached Q Condo/townhome (single family attached) 0 Duplex
Q Muttifamily (apartment) 13 Garage
If commercial, Is it: 0 Bank Q Bar G Church Q Hotel/Motel G Medical office C] office i7 Retail
12 Restaurant 0 Other (explain)
Is this buliding So years of age or more? D Yes O No If yes, you may need to contact ylstoric presenat/on
If this is for a demolition permit, what year was the building constructed?
ifplfor to 1975, yra/ W11 need an asheslvsassawment to subm/t w1th this application.
Description of wort( Eenlacina a fumace
*If lawn sprinklerAmckflow preventer, must list licensed plumber. If first-time AIC" must list licensed electrician.
Subconit actor., I& oe company name or Clty of Ft Collins /,tense'g
M&CMddn Plumber. Mechanical H-1654
RaoFer 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. 1 know that a
permit is not valid until'it has been paid and issued.
Applicant•. Shelly Swanson 1
Print Name; Slgnature ` ;% ��:y'� 1 e ) 6
Q`•-� d.� �_ Date
—Le