HomeMy WebLinkAbout1900 Pawnee Dr - Applications/Furnace - 08/16/2018FCity of Panning, Development, & Transportation Services
& t Collins Community Development & Neighborhood Services
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 O Gas Log
■ Heating Unit .❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo-voltalc
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ WoodlPellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all appilca inflo iofn onntthe
'application. Incomplete applicationswillnotbeaccepted.
Application # l�)V lVv Date
Forofte use only
lob Site Address (required) Value of Construction (labor, materials, profit)
D r ,
roperty OwW Name Address City/State Zip Phone
-ka
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 Zip Phone
Fort Collins Heating & Air 20B 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
S3/e9rarnwzberlsls7wmdbya#oaabad77s. Are you paying with your trust account? ■ Yes ❑ No
NMD
Is this a residential or commercial project? ■ Residential ❑ Commercial
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 50 years of age or more? ❑ Yes ❑ No If yes, you may need In contact Historic Preservation
If this Is for a demolition permit, what year was the building constructed?
Description of work>�
*If lawn sprinkler/baddiow preventer, must list licensed plumber. It first-time A/C, must list licensed electridan.
Subcontractors: List the company name or Qy of Ft Collins license 0
Eleciridan Plumber Mechanical H1309 RooferOther
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 not valid until it has been paid and Issued.
Applicant: i4m=k
Print Name: k Signature Date
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