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HomeMy WebLinkAbout3500 Carlton Ave - Applications/Water Heater - 09/26/2016Sep 2716 08:48a Swan Heating and Air 970-613-0826 p.1 OVEWTHE-POUA ThW appilctatlon to to he used W apg1Y f the tollov ❑ D®mofiifion (interior non-tnichual) Cl Il 'cal Aitac p HeMing Unit�SPrinkler Gt Mob a Home ral 0 V806I n er Heater ❑ Water L 13 Wool rrranufactdrer). Complete all applicable information on f e appiit:at Aj OICatieri RrroHAN use only Job Site AddrSM i'nel WW) Proppm Owner Name Applicant Name Contaacbor' Contractor City of tt: P3allins Sales Tao # Satz-, bpi#ambmlo►x 1 S tM a regdemal or commerdal project? If resiclenmI is t: 13 Single Family Dete 0 Multifamily (apartn If canimerciai,� is .It: C3 Bank C] Bar E3 13 Reblaurant !7 Is this building So yew of age or more? If this is for a deinaRt ion perml% v ldt Y+ ifAriarto 1075,1OL yyry/needan asbestas De9cription Of work Planning, Development & TransportW°a 281 N. College Ave P.O. Box 580 - - Fort Collins, CO 80524 Phone 970-4162740 Fax 2246134 pertnifis only (check all that apply). 0 Air Conditioning i (not saMce change) 0 Gas Lighter ❑ Gas Log meat E3 RooSng E3 Sewer Line CI Photo voltaic let Stove (must be EPA certified. Provide make, model and incomplete app1jeadons will not be accepted. gad. Dade � ��Q) ue of Cm0mcdon (labor, matieriials, l ) r�s Gty/State Trp Phone L, rem city/stow Zip Phone 3 AWitle i} E) Gal troll 13 Ho1 ter (explain; ;Yes 'Mig tars the but -I-If lawn sprinider1baddltow preverrbe� must 9 iramsw pzurnz 5ub=ntraefi W- -Stare cvrr►PanYriameor ' bfftcomas EfetUid�n I hereby acknowledge that I have read this; ication and Mmply vuidt all ne#ulremerm contained trOW , d M Oidl permit is not valid DrAn it has been paid imed- QpAl�iit: Pant NMW-f— Lk, Cfi!%State zip Phone9-70 you paying tw= hem or by riport? & 13RWort YOU paying WAh your trust account? es 13 No 0 Commercial ownhorne (single family arached) Q Duplex Mel © Medical office C3 Offtce 13Retail yarg, ywmay neaad hi, wn wthllstadePrese vahm constructed? r&web d*Bpzeya3fta- if fu"me AJC� must list licensed etedfldan. !se 0 Roofer ouw _ that the above information is oornplete and conVCL I agree to s and state lays regulating building construction. I know that a Datae2Z�Q,—