HomeMy WebLinkAbout2700 Stanford Rd - Applications/Furnace - 05/13/2016MAY-13-2016 02:57PM FROM -
9704948354 T-125 P-002/002 F-809
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
D Heating Unit U Lawn Sprinkler Q Mobile Home replacement ❑ Roofing ❑ Sewer Line O Photo -voltaic
Q 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 # ICJ I U 0 aGB Date
For ofte use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
2700 Standford Rd. #24
14,303
Property Owner Name Address
City/State Zip
Phone
Keith Smith 2700 Standford
Rd. #24 Fort Collins, CO 80525
(970) 443-4695
Applicant Name Address
City/State Zip
Phone
—Fort Collins Heating and Air 20A Commerce
Dr. 94 Fort-Colling, CO 5105-3479
Contractor Address
City/State, Zip
Phone
Fort Collins Heating and Air 208 Commerce Dr. #4 Fort Collins CO 80524
970 484-4552
Contractor City of R. Collins Sales Tax #
Are you paying taxes here or by report?
❑ Here ❑ Report
Sa/ec &x numberlsiWaired by all cwft i n
Are you paying with your trust account?
❑ Yes Cl No
Is this a residential or commercial project? * Residential ❑ Commercial
If residential, is it: ❑ Single Family Detached 0 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?
Jfprior to X97S, you will need an asbestos assessment to submit with this application.
Description of work
*If lawn sprinkler/backnow, preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subounttactors: Ust the company name or City of Pr Collins license #
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'lows 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 M lam_