HomeMy WebLinkAbout1421 Sheep Creek Ct - Applications/Water Heater - 01/30/2018qN05
,F0 C_cltyfll Planning, Development, & Transportation Services
`"�•��ns Community Development & Neighborhood Services
`f 281 North College Avenue
Fort Collins, CO 80524 Main: 970.416.2740 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). ❑ Air Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating 111 ❑ Lawn Sprinkler D Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ■ Water Heater ❑ Water Line 4 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 # �) `1160 00 Date 13 � I l40
ForoNke use only
Job Site Address (mqubed) value pf Wnstrutsion (labor, materials, profs)
�Pel tY Owner Name Address City/State Zip Phone
U` err
Applicant Name Address city/State Zip Phone
Fort Collins Heating & Air 208 Commerce Dr. #4 Fort Collins, CO 80524 970.484.4552
Contractor Address city/State Zjp Phone
Fort Collins Heating & Air 208 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
sans• cm wnbw lsMuhV by all Q°n&aI 1�1 rf /+�I Q Are You paying with your trust account? ■ Yes 0 No
Is this a residential or commercial project? 1"0 Residential ❑ Commerdal
If residential, is it: ■ Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, Is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building SO yews of age or more? ❑ Yes ■ No If yes, you may need to contact Historic Preservation
If this is fora demolition permit, what year was the building constructed?
Description of work 'Ylmmu TUTU
*If lawn sprinkler/backfiow preventer, must list licensed plumber. If first-time A/C, must list licensed elecbiden.
Subcontractors: Ust the company name or CIty of Gbl/ins /kense 0
Elecbioan Plumber Mechanical H1309
Roofer Other
I hereby admowtedge 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 bullding construction. I know that a
permit is not valid until It has been paid and issued.
Applice
Print Name. Signature v Date --
Rm4im data 242M7