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HomeMy WebLinkAbout636 Zuni Cir - Applications/Furnace - 04/07/2016Apr 06 2016 02.31 PM One Hour Heating & Air 9706634097 page 2 F b City, Collins Planning, Development & Transportation 281 N. 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). IN Air Conditioning ❑ Demolition (interior non-structurao ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log ® Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic ❑ Ventilation .❑ Water Heater ❑ Water Line ❑ W©od/Pellet Stove (must be EPA. certified, provide make, model an( manufacturer): Complete all kpplicable information on the application. Incomplete applicatio s wit be accepted. Application (g �J BOgb S ' j IoD f ED0 . Date /`vr ofte use only Job Site AddlrSSS (requlred) Value of Construction (labor, materials, profit) 636 Zuni Circle $7,992.00 Property Owner Name Address City/State Zip Phone Dave Batt 636 Zuni Circle Fort Collins, CO 80526 970-682-5618 Applicant Name Address City/State Zip Phone One Hour Heating & Air 487 Denver Avenue Loveland, CO 80637 970-663-4002 Contractor Address City/State Zip Phone One Hour Heating & Air 487 Denver Avenue Loveland, CO 80537 970-663-4002 Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? M Here ❑ Reporl Sales tax number: is required by all wniractnrs Are you paying with your trust account? S1 Yes ❑ No Is this a residential or commercial project? ® Residential ❑ Commercial If residential, is it: ® Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex ❑ Multifamily (apartment) ❑ Garage If commerdal, is It: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motei ❑ Medical office ❑ Office ❑ Retail ❑ Restaurant ❑ Other (explain) Is this building 50 years of age or more? ❑ Yes ❑ ND If yes, you may need to contact Historic Preservation If this Is for a demolition permit, what year was the building constructed? Ifpn'or to 1975, you will need an asbestos assessment to submit with this application. Description of work ive *If lawn sprinklerlbackflow preventer, must list licensed plumber. If first-time NC, must list licensed electrician. Subcontractors: List the company name or City of Ft Collins license # Electrician Plumber mechanical H-824 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 permit is not valid until it has been paid and issued. Applicant: Stacey Schmidt s ` iw# se"4ti Print Name: Signature Date