HomeMy WebLinkAbout1412 Osprey Ct - Applications/Mechanical - 09/23/2016 (2)SEP-08-2016 08:00AM FROM-
9704848354 T-146 P.024/025 F-81g
Fort Collons
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
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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
❑ Heating Unit ❑Lawn Sprinkler ❑ Mobile Home replacement Q 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 #_ 1 = �Q Date SEP 2 3 2016
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Job Site Address (required)
Value of Construction (labor, materials, profit)
1412- O 2
11-7t -364
Property Owner Name Address
Tian Berhosf- 1q1 Z Osprey
Clty/State Zip
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Phone
2 I;I-a q
Applicant Name Address
city/state Zip
Phone .
Fort Colfinq Heating and Air 909 Cilmmerce Dr.
#4 Fort Collins, rO 80574 9
Contractor Address
City/State Zip
Phone
Fort Collins Heatiniz and Air 208 Commerce Dr. #4 Fort Collins CO 80524 970
484-4552
Contractor City of R. Collins Sales Tax #
-Werewnumber 15reequnedbyall cono-ja .
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? 0 Residential ❑ Commercial
If residential, is it: ftSingle Family Detached ❑ Condo/townhome (single family attached) ❑ duplex
Cl 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 mayneed to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
Yprfor to 1975, y vu will need an asbesbs assessment to submit with this application.
Description of work
*If lawn sprinkler/backilow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontraebors: L& the company name or city of R callins license #
Electridan 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.
Applicant: /
Print Name; Angela Morrow W % �U I d J Ike
Signature rate �! � �!