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HomeMy WebLinkAbout3313 Oregon Trl - Applications/Furnace - 08/30/2017Aug 301708 49a Swan Heating and Air 970.613-0826 , p 1 - Planning, Developmen4 & Transportation Services FVirt^� Community Development & Neighborhood Services 281 North College Avenue Fort Collins. CO 80524 Main- 970.4162740 Fax 970 224.6134 OVER-THE-COUNTER PERMITS ONLY This application is to be used to apply for the following permits only (check all that apply). 0 Air Conditioning ❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log 'Heating Unit ❑ Lawn Sprinkler ❑ Motile Home replacement ❑ Roofing ❑ Sewer Une ❑ Photo -voltaic ❑ Ventilation O 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 # Z)\-105-6 - ftoriaA�- rvrofterseono, gno5333 Date --&C/ Job Site Address (required) Value of Construction (labor, materials, profit) no or -Wpo 00 3s00 Property Owner Name Address City/State Zip Phone m 33 l i S o 205ZU Applicant Name Address City/State Zip Phone Contractor Address City/State Zip Phoneme �y 'z .JO Contractor City of FC Collins Sales Tax # Are you paying taxes here or by report? Here ❑ Report Salesbwnumber snauiredbya#conoactom Are you paying with your trust account? Yes El No Is this a resdential or mmercial projects Residential ❑ Commercial If residential, s t: Single Family Detached ❑ Cmdo/bownhome (single family attached) ❑Duplex ❑ Kdtifamly (apartment) ❑ Garage If commeroal, is it: ❑ Bank L7 Bar ❑ Church 13 Hotel/Motel ❑ Medical office ❑ office L] Retail ❑ Restaurant ❑ Other( in Is this budding SO years of age or more? ❑ Yes No Ifyes, you may need io aontactHistonc Preservation If this is for a demolition permit, what year was a building constructed? Description of work 1Fjjrn810 11 YI M Rn ;000 1. -y-dje 7 544 *If lawn sprinkler/bad6low preventer, must list licensed plumber. If first-time A/C, must list licensed electrician. Subcontraac�t�ors. L&rr�U�u/eecompany name ofCtYvfF[CollinsGcense,0' Bectrioan—i Vvin h t IJVLJ Plumber Mechanical Roder 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 building construction. I know that a permit is netvali(d1 uhntlil ittlhas paid and issued. Ibeen Pricaft ' ntt Name: M (IRA 1V fla , Y Signature KA Date i a� sere nsrm»