HomeMy WebLinkAbout4805 Venturi Ln - Applications/Furnace - 12/10/2018Fort Collins
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
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
O 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 an the application.
Application #�
For office use only
Incomplete applications will not be accepted.
Date
12/10/2018
Job Site Address (requ/red)
Value of Construction (labor, materials, profit)
4805 Venturi Lane
$ 3067.00
Property Owner Name Address
City/State Zip
Phone
Barbara Witt 4805 Venturi Lane
Fort Collins, CO 80525
493-3272
Applicant Name Address
City/State Zip
Phone
Barbara Witt 4805 Venturi Lane
Fort Collins, CO 80525
493-3272
Contractor Address
City/State Zip
Phone
DC Shortridge dba Gary HIN 1314 Webster Avenue
Fort Collins, CO 80524
493-3272
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?
M Yes ❑ No
34734
Is this a residential or commercial project? 0 Residentlal ❑ Commercial
If residential, is it 0 Single Family Detached 0 Condo/townhome (single family attached) B Duplex
G Multifamily (apartment) 8 Garage
If commercial, is it. 0 Bank 0 Bar 13 Church 0 Hotel/Motel ❑ Medical office 9 Office 0 Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes ❑ No If yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
Ifpnor to 1975, you wAl need an asbestos assessment to submit with this application.
Description of work Replacing furnace with an 95% efficient 40K BTU gas furnace
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/c, must list licensed electrician.
Subcontractors: Ust the company name or City of Ft Collins license #
Electrician Plumber Mechanical H-1654 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: Dennis Shortridge Dennis Shortrid a= `= = '�"' 12/10/2018
Print Name; Signature g Date