HomeMy WebLinkAbout621 Stonington Ln - Applications/Water Heater - 10/29/2016Plzmrft Deve?opnjmnt & Trzii'lsportart:,o
281 N. College Ave P.O. Box
Fort I-Vflns, CO 80524
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Phone 970-416-27,10 Fcb/ 29zl-.�_)_'
Zr] apply forthe '01101wing permits only (Gheck vd! that apuly). 0 Air, Cordi:L-;crwig
used
a?,i..-.)1icat1on is ba
(not service change' 13 Gas Lighter E] Gas Lai_1annoHt;or. (Interior non-struCtLir2l) El Electrical Alteration
-inld 1-lone replacement El Roofing 101 Sewer Line 110 F'ho"O-VO!tSic
Ljji[t E! Law!. Spi er E71 Mobile I-lo
StoveCI V'anti!Zrio;
(must be EPA cerkilied, provide make,, mod..':,l Ewll-1
at-eF Heater 0i Water Line [3 Wood/Pellet
Coil"Plateall "Pr' ic-'- -the application. Incompiete FpPlicatiolls V1111 riot be acceptad.
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Po1. of "C'.? us�� only
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. ..... 'Vail:e cf-Con5t7.37ctiorj (labor, niaterials, prollF)
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Cjjjtj-pc::o: City of, Fit:. Collins Sales a), 1Are you paying taxes here. or by report? Are you paying with your trust aCCOL.jn-? ';�`/_YE
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'_rnmercia)
sidentia; L. Co
'amily
'A :-asidential; is igle Family z . attached
nily Detached Ej Condo/rownhome (single.1
MUltif2illily (apartment) D Garage
L! Bai- [- ChUrCh, 11 HOtel/MOtel 0! Medical offlize 'D Office D Rilil
is j�u: 17] Bank -:1 Other r (explain) . ......
D Restaurant: is ,
15 ',hiS DLIHCHII�C 50 W-�Z-_S Of age or r.-lore? FJ Yes CI No Ifyo.,7, You n7aYROCd tO c017 t)i-A 'tO'
-ia building constructed7
Ti this i.s for a clam—ClitiOn Pe2•" what ear was d
to 19 -73, you will 00cf P,7 a_,;Z)e,,tos assessment to submit with this ?pPlira i0w
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Description C) -------- -----
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11SCd PlUrnber. c . ii-?. r 1.
spi Inkler/baclu ]OW prevenLet', must list li�,e IF First-time AIC, 1111LISt list: 1;censed :'.la rr
Su b Co I 1':;'Fi Cto 1 -45: /. ist th,2 C017 71),:217Y /7j]/77,- CY UtY Of f__1 ('0//j/7,; 1'C_e'7'5e
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acknowiedge bloc have read cl-lis application and state Lhalt the above jrj[crmaUon is cot -tc. and
cojj,,j)jy with all reqt.fil-f!,Mein:s contained herein and city ordinances and state laws reguiat.ng oijilding constmltl')r�. 1 julot'V
per mIt if riot Valid U-7111i 'T i" :jas beo.n paid and issued.
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