HomeMy WebLinkAbout4203 Trail View Ln - Applications/Furnace - 11/04/2016_/3/2016 09:09 PDT TO:19702246134 FROM:7194807234 Page: 26
Fort 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
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applliic�a—bllee information on
the application. Incomplete applications will
J
will not be accepted.
/YApplication # i -� �b b WDate `�I
For office use only
lob Site Address (required)
Value of Construction (labor, materials, profit)
4203 Trailview Ln.
$5,311
Property Owner Name Address
City/State Zip
Phone
Michael Olsen 4203 Trailview Ln.
Fort Collins 80526
217-3373
Applicant Name Address
Fort Collin-, Heating and Air 208 Commerce
City/State Zip
Dr- 44 Fort Collins, CO 80524
Phone
(970) 305-3478
Contractor Address
City/State Zip
Phone
Fort Collins Heating and Air 208 Commerce Dr. #4 Fort Collins CO 80524
970 484-4552
Contractor City of R. Collins Sales Tax #
Are you paying taxes here or by report?
❑ Here ❑ Report
Sales tax number is requiredby all contactors
Are you paying with your trust account?
❑ Yes ❑ No
Is this a residential or commercial project? ® Residential ❑ Commercial
If residential, is It: ® Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it:. ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes ❑ No If yes, you may need to contact Historic Preservation
If this Is for a demolition permit, what year was the building constructed?
If piYor to 1975,' you will need an asbestos assessment to submit with this application.
Description of work ' replace furnace
*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 Collins //tense #
Electrician' Plumber Mechanical H1309 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: Angela Morrow Signature
10/6/16