HomeMy WebLinkAbout1463 Front Nine Dr - Applications/Air Conditioner - 09/11/2019.r(sUa•7
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Planrtirrp� DwAftprient It Tramporfation
281 N. Oollege Ave P.O. Box 580
Fort Collins, CIO 80524
Phone 970-416-2740 Fax 224.6134
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OVER-THE-COUNTER PERMITS ONLY
O Demolition (Interior O) Electrical Alteration ( service oning
chanp) 0 Gas Wier Gas Log
O Heatrrg unit 0 Lawn SprhVw 0 Mobile Dome replacement 0 Roofing 0 Sewar une 0 wwEo-vareic
11 VeMilatwt 0 Water Heater 0 Water Lire O Woodg2eM Steve (must be EPA oartltied. provide make, model and
manufaatu er). .
Compiets all ap~19 Information on the applteadon. Incomplete application vAN not be accepted.
Appiicatim It eJ I °I MFor afte sm a*
3
Date 9-6 /4
Sob sloe Addrece (MwlradJ
Vakw, oP .:etfsn (labor, mat a als, profit)
Property Owner Name Address
City/State ZIP"Phone
k6 Spa,AsqV'SA44-3/20
Applicant Name Address
MY/State ZIP Phone
Cor&adaor Address
0ty/Stabe ZIP Phone
r
3 -,zU-
Canbactor City of FE Collis Sales Tax #
Are you paying taxes here or by report? )( Here 13 Report
salesr�r� +der��npraadbya►amaac0M
Fr
Are you paying with yow bust account? 0 Yes 0 No
Is this a residential or axnmerdal project? )SIteddential O Commercial -
If residential, Is it: ` q$ftVle Family Detached 0 Cordo/k wnhome (single family ettadred) ,puplex
0 Mui ft* (apartment) 0 Garage
If commercial, Is It: 0 Bank 0 Bar 0 Church 0 HoWmoiel O Medical d iee 0 Office 0 Retail
O Restaurant O cidw (e qbw)
Is this buYding M years of age or more? D Yes D No IfM )w nrayneed to aw && Histork prM►srBar
If this is for a daragptin ponds; what year- was the bull ft cssstrtrc ed? -
IfpYar to 1975 )w oWl need an asfaslas asks i to srrdmit *0 M apdiatam
Description of work
*If lawn sprinkler/baddlow preveraer, must list kereed plumber. If first-time AIC, must list licensed electrician.
Subconbracbors., list the cogmWname or ay ofRCo&v Ccww if
PNr*w Roofer. Other
-
I hereby admowledge that I have read this appNcation and state that the above Information is complete and =red. I agree to
comply with all requirements contained herein and city ordinances and state laws.regulatrrg building mnstrudion. I know that a
Permit is not valid until it has bear paid and Issued.
Applicant:
Print Nam
Data 9-6 -/9