HomeMy WebLinkAbout3348 Santa Fe Ct - Applications/Furnace - 05/22/2017i/ 19/� -711-201701dR AM AMFXPT
TO: 19702246134 FROM944}ahg07234 T-404 P OU4M : F-3094
FCayof
"rt COltins
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 ❑ hoofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ 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 # b i P1 o a --�V g Date 5- as Y-7
For oA9ce use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
5SR
7
Property Owner Name Address
City/state Zip
Phone
L cgin.?R11-C.
Applicant Name Address
City/State Zip
Phone
Fort Collins Heating and Air 20R Commerce
Dr. ft4 Fort Collins. CO 80524
(970) 5-
Conbacbor Address
City/state Zip
Phone
Fort Collins Heating and Air 209 Commerce
Dr. #4 Fort Collins CO 80524
970 484-4552
Contractor City of Ft Collins Sales Tax #
Are you paying taxes here or by report?
❑ Here ❑ Report
14W taxnunrberxsrequiredbya/rambadom
Are you paying with your trust account?
❑ Yes ❑ No
Is this a residential or co7itocial project? GNtesidenttal ❑ Commercial
If residential, is it: ngle Family Detached ❑ Condo/townhome (single family attached)
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office
❑ Duplex
❑ 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 prior to 1975, you wi// need an asbestos assessment to submit wlbh this app/lcadon.
Description of work
*If lawn sprinkler/baddlow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or City of Ft Co#iris 1/dense 0
Electrician Plumber Mecharncai 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 budding construction. I know that a
permit is not valid until it has been paid and issued. I ,
Applicant:
Print name: Angela Morrow Signature
Date _ 51 tq / 1 I
all