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HomeMy WebLinkAbout3025 Cumberland Ct - Applications/Air Conditioner - 05/17/2016May 1716 08:48a Swan Heating and Air 970-613-0826 p.1 of Flirt cAhn 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). < Conditioning 0 9ermolifion (interior non-structural) ❑ Electrical Alteration (not service change) © Gas Lighter ❑ Gas Log 121'Heating Unit ❑ Lawn Sprinkler 17 Mobile Home replacement ❑ Roofing 0 Sewer Line U Photo -voltaic ❑ Ventilation 0 Water Heater ❑ Water Line ❑ WoodiPellet Stove (must be EPA certified, provide make, model and manufacturer). Complete all applicable information on the application. Incomplete applications will not be accepted. 610OZ6726- fvl-n as Application # B 14FQ ?-P Z !o — *4q" i C Date ` � -1 I --1 U r'Or Ofikl? Me 091Y iM2&ZILi rU Job Site Add (mi rraV Value of Construction (labor, materials, profit) 000 zf�rs Nf&fr )an �Pmpefty owner blame Address City/Stage Zip Phone Occp l In Sa 0-00L3 Applicant Name Address Ciity/Stat a Zip Phone Contractor Address Gty/State Zip Phone Q \L . v 00 $D . 15- Contractor City o . Collins Sales Tax # Are you paying taxes here or by report? 0 Report Mte Sales&rnumberismWkedbyallmnbadws Are you paying with your trust account? Q No Is this a residential or cocpmerdal project? 19"Residential 0 Commercial If residential, is it: Single Family Detached 0 Condo/townhome (single family attached) © Duplex 0 Multifamily (apartment) D Garage le, If commercial, is it: ❑ Bank ❑ Bar D Church ❑ Hotel/Motel ❑ Medical office Q Office ❑ Retail Q Restaurant ❑Other (explal Is this building 5d years of age or more? 13 Yes No Ifyes, youmayneed to cnnbciHistnric Plresenrat n If this is for a demolition permit, what year was the building constructed? If prior to 1975, you moll neeidan asbestos assezment to submit with Mis aAaAwtfon Description of work U/ i nt i hS-ta/,ICi _an *If lawn sprinkler/baddlow preventer, must list licensed plumber. If first-time Af C, must list licensed electrician. Subcontractors: UstGhe company narm orOty of Ft Collins Acense 0 Electrician Plumber Mechanical Roofer Other I hereby acknowledge that I have read this application and stage 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 mnstruction. I know that a permit is not valid until it has been paid and issued. Applicant. Print Name • I �