HomeMy WebLinkAbout4207 Manassa Ct - Applications/Water Heater - 09/28/2016in G-rd-T.
291 N. Callege Ave P.O. Bn-XX 580
Fort Collins, O 30524.-
?hone 970-4,16-2740
LF 1- L "Mix PE F
This applicafion is -to be used to apply f-T-or -ffi,-i foffoldVifl-o - pel-raits only lr-14eaL, all oat apply). 0 Air conditioning
F-!DemDrton(-fn,*Leriornon--.,,-t-uotur-..I)osec irical/Uteraiion(not service cfiapge) EiGas Lighter IDGas Lug
1-1 Heafing Unit t r 0 Photo -voltaic
,�3 Lavin Sprinider 0 Mobilehilome repfacement. 0 ROOM9 11 Sevie file
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VentilAtion N.- -1 RfaterUne D WoodlPelletlStpkfe (must ire IEPAcergred, provicIp make, i-nodel and
_' AWater Heater F
rrianustftE Tre6-
Compleba- all appT.-r2ble C;ri Ahe Incol-nPlete aP;q!Ca;W--iDTIs will not be 3r,(X--Pte4.
App(icatoll Date
For 'im use on!--
3ab Slim Addi-ass (requirer)f
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l3roperty Ovrner Name
Addre—Fs
Cityl-state E72— -ZI P
Phone
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Appricant PZir)
larne fiddress
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Phone
Address-.. Zip ?Hone
ContraLtol- CILY of Ft C.'affirls Sales Tax Are. you paying taxes here ar by report? 0 Here Li Report:
ailEs tmx nunItLer k rzm6mxi L-y all c.-.)nl-
Are you paying with Your trust account? 0 Yes J-j No
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is this a re6friential or , counmercial pWjeu? D Resiclmdal f I Comqercial Dliphrx
If — tiat, it: X9, Single Faradly Detached 0 CondoltDvinhome (single Irimily a1acile
ir-qidenis
F I MuWFamily (aparb-nent) F3 Garage
pd [2 Or, rice 0 Retail
-if cornMercial, Ls ft b Bank 0 Bar 0 Churut FI.Hote-11MOL-21 EI M ical offlice. i
01 Rataurant
is . this bui . ld-mg5iDycL-,,,-SoTageorrriorp-.I OYes mNo iryes, you may need toconjaItH. jS7Mft PresenfaliOn
if this Lq, ibr a dw.mIrdon perm-1-t, what year was the building constmCcec!7 rifth t7ifs application,.- -----
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If prior to 1.975, x/oij will need an asbe-Am assessment to submit.
-)ascription of wark
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�Vf lawre'sPrirjkJ4/bac-kflO%v PrevEn�r, pmu, t fist fic-emed plumber. T= fjrStrdrn,- A/C, Must listfl(-erlSed electricjan.
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caraparry ilvri2 er cit,,r of r—caiifis licerse
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-,te and correct 1 acre 0
hap - this application
t3y admmed-ge ghat 1 have read ti, liCati011 and state that thp- above infbrmaijon is complete th2at a
maiply vft aU requirament-5 m-riained herein at id dtj ardinance5 and sial:e falv-s rMulating building construdion. 1 knoiff
pmmflk is not Val': d Wfiffl WITaSS bt�-en OEM lati
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Appificaal-