HomeMy WebLinkAbout1806 Enfield St - Applications/Furnace - 07/31/2017J�3'77
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Planning, Development & Transportation
281 N. College Ave P.O. Box sso
Fart 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). O Air Conditioning
O Demolition (interior non-structural) 0 Electrical Alteration (not service change) ❑ Gas Lighter 0 Gas Log
O Heating Unit O Lawn Sprinkler 0 Motile Home replacement ❑ Roofing 0 Sewer Line 0 Photo -voltaic
❑ Ventilation 0 Water Heater 0 Water Line 0 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 # %Jy*u Date /-
Farofte usrp* -n dLfc3
lob Site Address iliepu#ed)
value of Construction (labor, materials, profit)
�0000
Property Owner Name Address
CIty/State Zip
Phone
/
S� -11A) 90,<,96
Applicant Name Address
pty/state Zip
Phone
Contractor Address
City/State Zip
Phone
Contractor City of K Collins Sales Tax #
Are you paying taxes here or by report? )8( Here
❑ Report
-Qft 4wnwnbwis
Are you paying with your taut account? 0 Yes
❑ No
Is this a residential or menial project? MResidential 0 Commerdal
If residential, is it: Single Family Detached 0 Condo/townhome (single family attached) ❑ Duplex
O Multifamily (apartment) O Garage
If commercial, is it: ❑ Bank O Bar 0 Church ❑ Hotel/Motel 0 Medical office ❑ Office O Retail
0 Restaurant 0 Other (explain)
Is this building 50 yearsof age or more? 13 Yes O No If yes, yvu may need to cnnbd H&Wric Presr'rrdtion
If this is for a dentolltion permit, what year was the building constructed?
Zfprior to 1975, ynu W//need an a 'etas assewrent to submit with this app✓/rabon.
Description of work
*If lawn sprinkler/baddlow preventer, must list Dowsed plumber. If first-time A/C, must list licensed eiectridan.
Subcontractors: List Me company name or oiy of R Collins &enw
Beoidan4W� F.&Lt Plumber rnea,aroml Roofer Other
I hereby acknowledge that I have read this application and state that the above information is complete and correct. I agree l o
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 Nam
Date 1114' 3/-1%