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HomeMy WebLinkAbout1245 Vinson St - Applications/Water Heater - 09/18/2018City of Planning, Development & Transportation Fry 281 N. College Ave P.O. Box 580 01 t 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 ❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic ❑ Ventilation O Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and manufacturer). Complete all applica nfo on on the application. Application # For office use only Incomplete applications will not be accepted. Date 09/18/2018 Job Site Address (required) Value of Construction (labor, materials, profit) 1245 VINSON ST $11595.00 Property Owner Name Address City/State Zip Phone BRIAN MILNER 1245 VINSON ST, FTC CO 80526 970-231-5611 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? 0 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? O Residential ❑ Commercial If residential, is it: El 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 0 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 WATER HEATER *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 Print Name: KARENA HUNTWORK Signature HUNTWORK wi.:om eu.�.,ir�mu.Pis of w11 ,a as1' s.�w Date 09/18/2018