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HomeMy WebLinkAbout547 Spin Drift Ct - Applications/Furnace - 05/05/2016of Fart 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). ❑ Air Conditioning ❑ Demolition (interior non-structural) ❑ 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 ❑ 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 # IN �P 0 a 3� 5 Date 6 (C-/ / L0 For office use only Job Site Address (required) Value of Construction (labor, materials, profit) 4 S L5z�I Ima C6 Property Owner Name Address City/State Zip Phone c v irk �- ri r�C I ve P06Q\4114 4 ©lk ft -734 012,h 2,22 3�< Applicant Name 1-11 Address City/State Zip Phone Contractor Address City/State Zip Phone IA C: U1L 3D CD 3 �1Z- Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? Here ❑ Report Sales tax number'srequiredbyall contmctors Are you paying with your trust account? Yes "o Is this a residential or commercial project? d13Residential ❑ Commercial If residential, is it: W-Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex ❑ Multifamily (apartment) ❑ Garage If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office .❑ Retail ❑.Restaurant ❑ Other (explain) Is this building 50 years of age or more? ❑ Yes ❑ No If yes, you may need to contact Historic Preservation If this is for a demolition permit, what year was the building constructed? If prior to 1975, you will need an asbestos assessment to submit with this application. Description of work *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 # 1 P&_ 4 Electrician Plumber Mechanical 4-1 k37- 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. Applican Print Na"" LMe-AvCk_ [('e J a .g Date .l�2 (E'0 61K