HomeMy WebLinkAbout2145 Mainsail Dr - Applications/Water Heater - 10/04/2016OCT/03/2016/MON 10:14 AM
FAX No,
P. 004
CIO
Fort Collins
Planning, development & Transportation
281 N. college Ave P.O. Box 580
Fort Collins, CO 8o524
Phone 970-416-2740 Fax 224-6134
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) 0 Gas Lighter 0 Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement 0 Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation N(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 b d
Application # b 5
For offit"ie use only
e accepte .
Date m Lf I
Is this a residential or commercial project? IfResidential ❑ Commercial
If residential, is It, ❑ Single Family Detached to Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) CI Garage
If commercial, is It: 0 Bank 17 Bar ❑ Church Q Hotel/Motel ❑ Medical office ❑ office ❑ Retail
❑ Restaurant ❑ Other (explai
Is this building 50 years of age or more? 0 Yes ErNo If yes, you may need to cantact Historic preservation
If this is for a demolition permit, what year was the building constructed?
If prior to 1975, you wll/need an asbestos assessment to submit with this application.
Descriotion of
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors; List the company name or City of a Collins license#
Electrician plumber Mechanical_ — 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' Signature
Date, 1 b -51 I,o