HomeMy WebLinkAbout4442 Viewpoint Ct - Applications/Furnace - 09/23/2016ref x .. ��,:� =� �, w 3 � •� ��.�
Planning, Deydopment & Transporta-tlon
28.1 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
This application is to be used to apply for the following permits only (check all that .apply). ❑ Alr Conditioning
U Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
t
eating Unit ❑ Lawn Sprinkler ElMobile Home replacement ❑ Roofing ElSewer Line ❑ Photo -voltaic
entilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model ar-ld
manufacturer).
Col;�plete all applicable information on 'the application. Incornplete applications will not be accepted.
At)oliCatlorl # Y_ �O Date --
For office use on//
Sob Site Jiddres- (required) — V lue of-Coi7s't,ruction (labor, materials, profit) --
`rr 1� w 0 ► n� C� 0 p s 90 Ito
Propel't Owner Na ie Address City/State Zip Phones
A�pllcant e
Address City/State Zip Prone
Nam
C ontraclolt Address City/State Zip Phone —
:# t S- Ad d. : 10,a�' �
Contractor City of Ft. Collins Sales Tax ir Are you paying taxes here or by report? L1 Here ' I�,Report
21.st3Anumberisicquiredbyall contractors Are you paying with your trust account? `y 'Yes ❑ No
Is this a residential or cornmercial project? 36Residentlal ❑ Commercial
if residential, Is it: �ingle Family Detached ❑Condo/townhome (single Family attached) ❑ Duple:<
❑ Multifamily (apartment) L7 Garage
Ir commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
rs this building .5o years of age or more? ❑ Yes ❑ No If yes, you may need to Contact f/istoricPr2ser✓ation
If this is for a denaolitio!3 parmit, what year was the building constructed? . ... ...... ..... .... ..........
If picot to .1975, you Awli,1111d an asbestos assessment to submit' tn�ith this app/icatinn.;;�
Description of woryQ ill
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[F lawn sprinkler/backPlow preventer, must list licensed plumber. IF first-time A/C, must list- licensed electrician.
Subcontractors: ListthaCon panynameorCityofFtCollins license#
Humber.
Mechanical__ -- Roofar __ _.— Other
r iicreby acknowledge that I have react this application and state that the above information is complete and correct. I agree to
comply avith ail requirements contained Herein and city ordinances and state laws regulating building construction. I know that a
permit is not valid until it lips been paid and issued.
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Applic<,rtPrint Vate
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