The URL can be used to link to this page

Home My WebLink About3336 Oregon Trl - Applications/Water Heater - 10/07/2016From 9702299983 1.970.229.9983 Fri Oct 7 16:03:17 2016 MDT Page 4 of 5 FROM : FAX NO. : [T��i•��Ft•�t•H�F�a��1Q• City c)f F6ra 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 usod to apply for the following permits only (check all that apply). ❑ Air Conditioning ❑ Demolition (interior non-structural) FJ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log ❑ Heating Unit n Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing „Ci Sewer Line fl Photo -voltaic • Ventilation n Water hleater ❑ 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 /lI J.I � v \Y \.1Date ,10/07/2016 For office rise only Job Site Address (required) 3336 OREGON TRAIL Property Owner Name DIANE CACIOLA Applicant Narfic Value of Construction (labor, materials, profit) $1,295.00 Address City/State Zip 1336 OREGON TRAIL, FORT COLLINS CO 80526 Phone 970-225.9515 Address . City/State Zip Phone Contractor Address City/State Zip Phone NORTHERN COLORADO AIR INC. 812 STOCKTON AVE, FT COLLINS CO 80524 970'-223-$$73 Contractor City of Ft. Collins Sales Tax # Sales tax number is requim)d Uy sii rrmtractom 26862----.._....... Are you paying taxes here or by report? L■l Here ❑ Report Are you paying with your trust account? ® Yes ❑ No Is this a residential or commercial project? Lil Residential ❑ Commercial if residential, is it: EI Single Family Detached ' i] Condo/townhome (single family attached) ❑ Duplex ❑ Multifamily (apartment) ❑ Garage If commercial, is it: ❑ Bank 11 Bar ❑ Church 11 Hotel/Motel ❑ Medical office U Office ❑ Retail © Restaurant ❑ Other (explain) Is this building 50 years of age or rnorce ❑ Yes ® No 1f yes, you may need to contact Historic !'reservation If this is for a demolition permit, what year was the building constructed? If pnor to 1975, you will need an ashestos assessment to subn?lt with this application. Description of work REPLACE WATER HEATER *Ir lawn sprinkler/backfiow preventer, must list licensed plumber. if FrSt-tirne A/C, must list licensed electrician. Subcontractors: List the company name or City of Ft Collins lirense f/ Electrldan . dumber. Mechanical Other I hereby acknowledge that T 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 untiil it has been paid and issued. Applicant: print Name: KARENA HU,NTWORK signature KARFNA HUNTWORK G^i. nnttin — ........ 4/+GnrmrrGyL!N. Date 10/07/2016 _.-.....