HomeMy WebLinkAbout3615 Rocky Stream Dr - Applications/Furnace - 02/29/2016FES-29-2018 11:37AM FROM-
9704848964 T-468 P.002/004 F-405
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Planning, Development & Transportation
281 N. College Ave PA. 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) ❑ Gas Lighter Q Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ 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 #?pl to D 12(0 Date
For ofTrte use only
Sob Site Address (required)
Value of Construction (labor, materials, profit)
Property Owner Name Address
Keri/Kent Crews 3615 Rocky
City/State Zip
Stream Dr. Fort Collins CO 80528
Phone
282-1769
Applicant Name Address
Fort Collin-, Heating and Air 208 Commerce
City/State Zip
Dr. #4 Fort Collins, CO 80524
Phone
(970) 305-3478
Contractor Address City/State Zip
Fort Collins Heatine and Air 208 Commerce Dr. #4 Fort Collins CO 80524
Phone
970 484-4552
Contractor City of R. Collins Sales Tax #
Sa/es&xnumber isrepuvedbyall con&ackim
Are you paying taxes here or by report?
Are you paying with your trust account?
❑ Here ❑ Report
❑ Yes ❑ No
Is this a residential or commercial project? Et Residential E3 Commercial
If residential, Is it: %Single Family Detached ❑ Condo/townhome (single family attached) 13 Duplex
O Multifamily (apartment) ❑ Garage
If mmmercial,.is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office n Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? t3 Yes D No If yes, yoU may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
lWor to .1975, you will need an asbestos assessment to submit with this application.
Description of work
*If lawn sprinider/baddlow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Suboontractars: L& Me company name or City of Coll/ns 11cease #
electrician Plumber Mechanical H1309 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 Name: Angela Morrow Signature
Date,