HomeMy WebLinkAbout2300 Moss Rose Ln - Applications/Furnace - 05/12/2017May 06 2000 0724AM One Hour Heating & Air 9706634097
page 2
This application Is to be
❑ Demolition (interior non
® Heating Unit ❑ Lawn
❑ Ventilation ❑ Water Hr
manufacturer)
Complete all applicable
Application # b r
Farofte i
281 N Cc
Fort Collir
Phone 971
AME-COUN�ER PER
to App, for the follwMhg permits only (,
turit 9 ❑ Electrical Alters on (not service ct
der ❑Mobile Home repl Dement ❑ Rood
❑ 1 Vater Line ❑ Wood ellet Stove (must
nat on on the appllcat"In Incomplete al:
a3
Date —
1%n?501
relopme t 8 1
Ave P T Box
n 80524
IIT3 ONLY
ck all thatapply) 11131 Air itionnng
Ie) O Gat Lighter a Log
❑ Sewer Line ❑ P o italc
EPA cerbfi , provid k , model and
not be
]ob Sift Add
1
Value of
Coratructiori
(labor, am
terliIs
profit)
2300 Moss Rose Lane
$15,386
30
,(Qq
Property Owner Name
Address City/Stage
7jp
Phone
Sarah and Chris Fulkrod
2
00 Moss Rose Lane Fort Collins,
CO 8
526
9
1-9823
Applicant Name
Address City/State
p
Phone
One Hour Heating & Air
47
Denver Avenue Loveland,
537
7
282-5769
Contractor
Address City/State
p
Phone
One Hour Heahng & Air
4
87 Denver Avenue Loveland,
CO 8
537
292-5769
Contractor City of ft Cdll
s
les
ax # Are you paying
es here or by
nepnrt?
H
❑ Report
a
Saks xnumb number miqulred by
Are you paying wl
your trust a
nt?
Y
❑ No
Is this a residential or con
1 p
Jam? M Residenbal ❑ Commercial
If residential, is it ®Si
amil
Detached ❑ Condo/townhome (sing)
famlly attach
) ❑
upl
❑ Mull
ly (
rtment) ❑ Garage
U commercial, is it ❑ Be
❑ Church ❑ HoteVMotel ❑ Medical
office ❑ Olfi
❑
d
❑
nt
❑ Other (explain)
m contact
ntnxrc
Is this budding 50 years o
If this is for a deriiolttlon
a
or
It
ore? O Yes ❑ No tfyes/ ynu may
t year was the building constructed?
an
If Prior to 1975, ynu wV/!
assmsntertt m sllblmlt wrdh NNs WIL
Description of work Re
la
fui
nace,AC and evaporative coil
*If lawn spdnkier/baddlow
Subeuntrmtors: List the ca
8ectiidan
rffl
u
ter,
ir 7y na
r
mnust list licensed plumbler If first time A/C,
we or OW &H Cou/es baenshe 0
Mechanical H-824
must list 111censt
Roofer
OLM
I hereby acknowledge that I I
comply with all requirements
permit Is not valor until tt
ave
:or
mobeer
read
it 31ned
this application and state that the above mr
herein and city ordinances and state laws ngulating
paid and issued.
rmatlon Is coin
bukldkn
lete and o)rrat
)construct
on
Ilknowthato
I agree to
Applicant' Stacey Sch
nc
Print Name
�+
Signature `7
pate 0!
017