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HomeMy WebLinkAbout6313 Compton Rd - Applications/Furnace - 02/13/2019Planning, Development & Transportation Fort Collins Fort N. College Ave P.O. Box 580 Collins, CO 4 Phone 970-41616-27402740 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 I] 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 laication. Application # \I For office use only Incomplete applications will not be accepted. Date 2/13/2019 Job Site Address (required) Value of Construction (labor, materials, profit) 6313 COMPTON RD $4,900.00 Property Owner Name Address City/State Zip Phone LANY SCHUTT 6313 COMPTON RD, FTC CO 80525 970-214-5526 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? EI Here ❑ Report Sales tax number is required byall mntractom Are you paying with your trust account? 0 Yes ❑ No 26862 Is this a residential or commercial project? 0 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 N No Ifyes, you mayneed 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 95% *If lawn sprinkler/bac0ow 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 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 MMAREN V 1®N VfYiIF W 4. w�4 ow:xmaoiain�i m mm Date 2/13/2019