HomeMy WebLinkAbout2830 Teal Eye Ct - Applications/Furnace - 09/17/2018Planning, Development & Transportation
City Of 281 N. College Ave P.O. Box 580
Fort Collins Fort 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). ❑ Air Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
El Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ 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 # u(b u bc)U-1 Date
For offlce use only
09/17/2018
Job Site Address (required)
Value of Construction (labor, materials, profit)
2830 TEAL EYE CT
$2,330.00
Property Owner Name
Address City/State Zip
Phone
SANDY LECAIN
2830 TEAL EYE CT, FT COLLINS CO 80526
970-282-7727
Applicant Name
Address City/State Zip
Phone
Contractor
Address City/State Zip
Phone
NORTHERN COLORADO AIR INC.
812 STOCKTON AVE, FT COLLINS CO 80524
970-223-8873
Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report?
17 Here ❑ Report
Sales tax number is required by all contractors
Are you paying with your trust account?
O Yes ❑ No
26862
Is this a residential or commercial project? 0
If residential, is it: 17 Single Family Detached
❑ Multifamily (apartment)
If commercial, is it:
Residential ❑ Commercial
❑ Condo/townhome (single family attached)
❑ Garage
❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes E No If yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
If prior to 1975, you will need an asbestos assessment to submit with this application.
Description of work REPLACE FURNACE 80%
❑ Duplex
❑ Retail
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/c, must list licensed electrician.
Subcontractors: List the company name or City of Ft Collins license#
Electrician Plumber.
Mechanical Roofer
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 not valid until it has been paid and issued.
Applicant: KARENA /"u^ .°—.-".A.1'"°°"
:m � K.ENAHU «°a s
Print Name: KARENA HUNTWORK Signature HUNTWORK a,p„o,a.,.��am Date 09/17/2018