HomeMy WebLinkAbout1807 Remington St - Applications/Furnace - 09/26/2016SEP-21-2016 09:42AM FROM -
9704648354 T-273 P.003/013 F-317
port 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
O 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 # '& W9U 11
. For office use only
Date 1�9' 1�9
Job Site Address (neiqukad)
Value of Construction (labor, materials, profit)
Property er N ddress
Am 11 7 -
City to
ICY
Zip
S 6
Ph;�ftv�
9
Appli nt Name Add
City/State Zip
Phone
lFnrt CnIlinq Heating and Air 209 CamrnCMe
T)r. #4 Fort Collins- CO 80524 9
4
Contractor Address City/State Zip
Fort Collins Heating and Air 208 Commerce Dr. #4 Fort Collins CO 80524 970
Phone
484-4552
Contractor City of R. Collins Sales Tax #
Saft Aw number Is Waked by all wmftw&s,
Are you paying taxes here or by report? ❑ Here
Are you paying with your trust account? ❑ Yes
❑ Report
❑ No
Is this a residential or commercial project? residential ❑ Commercial
If residential, Is it: single Family Detached ❑ Condo/townhome (single family attached) 17 Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is It: Cl Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office 13 Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building So 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?
Ifpnror iv,1975, you wi/l need an asbastas assessment to suhmlt 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., Ust the company name or City of Ft 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 laws regulating building construction, I know that a
permit is not valid until it has been paid and issued. A
Applicant:
Print Name: Angela Morrow Signature