HomeMy WebLinkAbout1409 Reeves Dr - Applications/Water Heater - 10/31/2016OCT/31/2016/MON 10:21 AM
FAX No,
P. 002/002
FCity of
lirt 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 ISM hw t"RPri to wrply for tho following porml#a only (check all that apply). ❑ Ail CuiWitimiltiy
❑ Demolition (interior non-structural) El Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement 0 Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation VWater Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable
�information
j on he application. Incomplete applications will not be accepted.
Application #_ �1y�`�l l Date
For offitim use only
Is this a residential or commercial project? LgResidential ❑ Commercial
If residential, is it: 0 Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, Is it: ❑ Bank ❑ Bar Q Church ❑ Hotel/Motel ❑ Medical office ❑ office ❑ Retail
❑ Restaurant ❑ Other (explai
Is this building SO years of age or more? A Yes WNo If yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
If prior to 1975, you w/I/ need an asbestos assessment to submit with this application.
Descrintion of work
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electridan,
Subcontractors: List the company name or City of,&t collins license 0
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: 1(JL>r Signature Q�.p�..�.Q r�,,�,� patq 96 31