HomeMy WebLinkAbout5036 Saffron Ct - Applications/Water Heater - 01/08/2019City of Planning, Developmen4 & Transportation Services
/Fort Collins Community Development & Neighborhood Services
281 North College Avenue
Fort Collins, CO 80524 Main: 970.4162740 Fmc: 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 Unit P1 Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation YA 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 #S�U,111'1)kn Date rcanu.uwv 8.2019
For of RL-we carry
lob Site Address (iequbed) Value of Construction (labor, materials, profit)
5036 SaffvovvCou4 F6rtCoUZn4; CO 80525 $2272.00
Property Owner Name Address City/State ZIP Phone
jeavu%eavvBaa-ney 5036 SafjmwCaurt FortCoU&w,, CO 80525 970-494-7632
Applicant Name Address Zip
Chrl.Wr WIIEVa4U 101 S U r&lLa w-, FtCsoth,CCO 80524 494 632
Contractor Address aty/stale Zipp Phone
AUevv$ervLCn
e 101 S LLr&1Lae FVC0, CO 805z4 484-4841
Contractor City of FL Collins Sales Tax # Are you paying farces here or by report? ❑,Mere ❑ Report
Sdkstar numbwr&MWMedbyaVMI&a Are you paying with your trustaceount? VYes ❑No
10010
Is this a residential or c9mntercial project? Zesklential ❑ Commercial
If residential, is it vfsingie Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it. ❑ Bank ❑ Bar ❑ Church ❑ Hohel/Motel ❑ Medical office ❑ Offloa ❑ Retail
❑ Restaurant ❑ Other (eVlain)
Is this building 50 years of age or more? ❑ Yes ❑ No Yyes, you mayneed to aontartffisWcPAmwt7on
If this is for a demolition permit, what year was the building constructed?
Description of work RemoV&egzWL#`g"w/lvan&rePZac&w'tivnew Uke w/Iv
*If lawn sprinkler/baddlow preventer, must list licensed plumber. if fnst-time A/C, must fist licensed electrician.
subcontractors: List thecvmpanynameorGlyofftCoWnslicense#
9ecbidw Plumber Mechanlcat Roofer Other
-
I hereby acknowledge that I have read this applimbon and state that the above information is complete and correct I agree to
comply with all requirements contained hereln and city ordinances and state laws regulating budding construction. I know that a
permit is not valid until it has been paid and issued.
Applicant: C1W6WEtNLa1Eva4 U �� �U� G CO Print Name: Signature Date
ReASIen dale 26=7