HomeMy WebLinkAbout2201 Stetson Creek Dr - Applications/Water Heater - 07/28/2017Planning, Deveic
281 N. College Ave
i' r Z i tl yy Fort Collins, CO 8011
Phone 970-416-27-'
I' , _;policatio;l is to be used'to apply for the following permits only (check all t�
::•n;oIitioil (interior non-structural) ❑ Electrical Alteration (not service change) ❑ I
l 1-I inting Unit Ll Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sew
i ventilation aier Heatei ❑ Water Line Wood/Pellet Stove (must be EPA ce
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;onlplote all apq},:,abla inforr4ation on the aAplication. Incomplete applications
'alion , , I - Date
lu offico use only
— -- 1— Value of Cot,struct
A dd 1liess (/,n u/!c',FC%).(\(—
Ly Owner Name Address City/State
____
i Aauiicanl anse< l Address City/State
-� I rc' C
Address City/State
ly;,�Lf,i
mUado[ City of Ft. Collins Sales Tax #
lumbar rs regwred by d/l conhiactors
vent Vfiansportadoii
P O Box 5.90
Faa Lr_� 613 -'
aNLy
at apply). G Air Condil On', o-
ias Lighter I l Gas Loq
it Line ❑ Photo -voltaic,
tfied, provide make nrxl.a ,a
not be arcailiod
(labor, mal.eiidls,
prolix)
Zip
LU
Pholia
Zipl
Zip
Phone
Are YOU paying taxes here or Py report? ❑ Here
Are you paying with your Lru account? 72,Yes
is [Ills .l iv lltiai o[ comerialproject? ❑Residentiai ❑ Commeroal
iial, i; it 0 single Family Detached ❑Condo/townhome (single family ab
❑ Multifamil`y (apartment) ❑ Garage
,i u)qunc [dal, r; il. ❑ Bank ❑,Bar ❑ Church ❑ Hotel/Motel ❑Medical office ❑
❑ ResLaurant ❑ Other (explain) ____-----
I n 11ldliiq So years of age or more? ❑ Yes ❑ No If yes, you mayneed to cox
;; for a dan.o!ition peririi , what year was the building constructed7
r, a to t 475, you will need an asbestos assessment to submit with this applrrabon.
q..noii of work Due -- -( �—
I r 1, wn Bpi inkier/backnow prevej)Ler, must list licensed ptumbei If first-time A/C, must list
S,-co':ilactols.liStUlaronlpanynameorGryofFtCollinslicense:.'
Piumber_ ._
Mechanical_____.—__ Roofer
'hv Id�nowloilye Lhat I have read this application and state that the above information is cp
,111ph' vv[gh all requirements contained herein and city ordinances and state laws regulating built
_„ `,! i_� oot valid un i itt has been paid and issued.
❑ UuplaA
q
'�Rci�oi r 1
CJ No
-e ❑ Retail
l-listorlc Preservarrnn
electi ir[an.
ete and con KI. t agrel.' is
constn[cbrni
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m Y in l c� ° 117
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