HomeMy WebLinkAbout1013 Tierra Ln - Applications/Mechanical - 06/25/2017Jun 25 2017 0&21AM Wry Hooley HVAC 9702241108
Pose 3
"iof Collins
Planning, r1so opment ik Transportation
261 N. College Ave P.O. Box 500
Fort Coffins, CO 80324
Phone 970-416-2740 Fox 224.8134
OVER-THE-COUNTER PERMITS ONLY
This application Is to be used to apply for the following permits only (oheokall that apply). m Alr Conditioning
O Demolition pnterlor non-structural) D Electrical Alteration (not service change) O Gas Lighter O Ose Log
G Heating Unit O Lawn Sprinider O Mobile Home replacement D RoaRng C Sewer Una O Photo-voltalo
O Ventllatlon t7 Water Heater 0 Water Line 12 Wood/Pallet Stove (must be EPA certified, provide make, model and
manufaoturer).
Cosnplats all appilaable Information on the applioadion. Incomplete applications will not be accepted.
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Job She Address (mqr oad)
Vahm of Constructfon (cher, materials, profit)
1013 Tierra Lane, Unit A
SZ929.00
Property Owns• Name Address
Clry%Stetle Zip
Phone
Obsidso LLC 3500 John F. Kennedy Pkwy. Fort CoWna, CO 80525
223-6500
Applicant Name Addrew
City/State ZIP
Phone
Obaldeo LLC 3600 John F. Kennedy Pkwy. Fort Collins. CO 80625
223-5500
Contram Address
O!y/Zotate ZIP
Phone
DC Shortridge dba Gary Hil 1314 Webster Avenue
Fort Collins, CO 80524
493tii' 272
Contractor City of Pt. Collins Select Tax d
Are you paying t ixes here or by report?
® Here t7 Report
aaei aw emnbfrbrae*dbyad'maelamari
Are you paying with your trust account?
tit Yee G No
$4»a
is this a residential or commertdal pro*0 ■ Residential O Commercial
If residential, to It: G Single Family Dated ed O CmuWbownhome (single family attached) 0 Duplex
® Multlfamlly (apartment) 17 Garage
if commerda4 Is R: O (lank CI Bar C7 Church Q Hotel/Motel C Medical office G office O Reta►I
17 Restaurant 17 Other (exploln)
is this budding 50 years of age or morel t7 Yes O No 0)eel, )tw may need m m9f et Nlslon+c• Phaw wfim
If this Is ibr a demeiltlen permit, whet year was the building constructed?
lrpv for to 107X ym u v& nm dsn aaooe9w awmrevrt m arrEvn/t ma their apse
Dewmptlon of work InaM112 ton enndend.n unit
*If lavrn sprtnMer/backRow prevlenber, must list licensed plumber. I f ro"me A/4 must list Ikermd electrician.
Subcartracborat Lbt the anrrpenynrrrrs or CO' o/R CbAIVas AEaens�s d
oWnClen Creakelde Electric pkantper. Medlanl®l H-1654 Rmft Other
I hereby ocicowledge that I have road this application and state that the above Information Is complete and correct I ogres to
comply with all requiremema tontalmd herein and city ordinances and state iawe regulating building construction. I know that a
porndt Is not vaiid unto It has been pall and Inued.
AWnMft
Print Name- Shelly Swenson 8lanatitn�r1�,Lu A d&w Date.Uz6(tz ...�