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HomeMy WebLinkAbout3525 Auntie Stone St - Applications/Furnace - 10/11/2016From 9702299983 1.970.229.9983 Tue Oct 11 16:08:16 2016 MDT Page 4 of 4 FROM : FAX NO. : Oct. 11 2015 10:06PM P4/4 ai.y Of F6rt 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 CI Demolition (interior non-structural) C! Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log EI Heating Unit E7 Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing El Sewer Line 0 Photo -voltaic ❑ Ventilation El 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 # 51,100 (011 k Date 10/11/2016 Par ohm use only Job Site Address (required) 3525 AUNTIE STONE ST #10 Property Owner Name DORIS PELLEMEIER Address Value of Construction (labor, materials, profit) $1;880.00 _ City/State Zip Phone 3525 AUNTIE STONE MOW, FORT COLLINS CO 80526 970-491-9536 Applicant Name Address City/State Zip Phone Contractor Address City/State Zip Phone NORTHERN COLORADO AIR INC. 812 STOCKTON AVE, FT COLLINS CO 80524 970-223-8873 Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? IF] Here ❑ Report Sale; taxnurnber;;rrequired byall convac ls. Are you paying with your trust account? m yes ❑ No 26862 _ Is this a residential or commercial project? IHI Residential © Commercial If residential, is it: ❑ Single Family Detached El Condo/townhome (single family attached) 13 Duplex ❑ Multifamily (apartment) ❑ Garago If commercial, is it: 13 Bank ❑ Bar ❑ Church Cl Hotel/Motel 0 Medical office ❑ Office Cl Retail ❑ Restaurant ❑ Other (explain) _ Is this building 50 years of age or more? ❑ Yes ® No If yes, you may need to contact Historic Presetvatlon If this is for a demolition permit, what year was the building constructed? _ If prior to 1975, you will need an asbestos assessment to submit with this application. Description of work REPLACE FURNACE 80% *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 Ft Col/Ins llcagse # 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. x know that a. permit Is not valid until it has been paid and issued, Applicant: KARENA Print Name: KARENA HUNTWORK Signature I�IUNTWORIt .. 9 __ _ .... Date 10/1112016