HomeMy WebLinkAbout2733 Bianco Dr - Applications/Furnace - 07/18/2016MAR-04-2010 09:50AM FROM-
9704648364 T-512 P.002/002 F-465
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planning, Development & Transportation
281 N. College Ave P.O. Box 980
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-strueturan 13 Electrical Alteration (not service change) ❑ Gas Lighter O Gas I_og
13 Heating Unit ❑ fawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo voltaic
13 Ventilation ❑ Water Heater ❑ .Water Line El 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 # S1 Ig 012B2 . Date
Farg as rye only
3ob Site Address (mqu/redj
Value of Construction (labor, materials, profit)
Propertjr Owner Name Address
City/State Zip
Phone
2
2
3%
Applicant Name Address
City/State Zip
Phone
S
5_
Contractor Address
City/State Zip
Phone
Fort Collins Heating and Air 208 Commerce Dr. #4 Fort Collis CO- 80524 9 0
494-4552
Contractor City of FL Collins Sales Tax #
Are you paying taxes here or by report? ❑ Here
M Report
Sw&wnumWisrequmedbyaNwnp'aCl m
Are you paying with your trust account? E3 Yes
❑ No
Is this a residential or commercial project? lKResidential O Commercial
If residential, is it: 19 Single Family Detached ❑ Condo/townhome (single family attached) 13 Duplex
❑ Multifamily (apartment) 13 Garage
If commercial, is It: ❑ Bank O Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
d Restaurant O Other (explain)
Is this building 50 years of age or more? ❑ Yes 13No Kyes, you may neied to contact Histor/c Preservation
If this is for a demolition permit, what year was the building constructed?
Ifp►ior to 1993, you wi// need an asbestos assessment to submit with this app/icalion.
Description of worts
*If lawn sprinkler/baddiow preventer, must list licensed plumber. if first-time A/C, must list licensed electrician.
Subcontractors=: Ustt6e odmpanynww or OW of FtGoIllnsl/ciense
Sectrician Plurnber Mechanical H1309 Roofer Other
I hereby admvdedge 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 iifiame: Angela Morrow signature
Date ZAWA6