HomeMy WebLinkAbout1213 Columbine Ct - Applications/Furnace - 12/10/2019WCity of planning, Development & Transportafion Services
t GO has Community Development & Neighborhood Services
281 North College Avenue
Fort Collins, CO 80524 Main: 970.4162740 Fax 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 ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer line ❑ Photo-vaitaic
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ WoodlPellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable Information on the application. incomplete applications will not be accepted.
Application #
Faroliice we o*
Dale December 9, 2019
Job Site Address (required) Value of Construction pabor, materials, profit)
1213 Columbine Ct, Ft Collins, Colorado 80521 $5513.00
Property Owner Name Address city/state Zip Phone
Suzanne Enman 1213 Columbine Ct Fort Collins, CO 80521 970-484-4565
Applicant Name Address aty/State Zip Phone
Christina Evans 1015 Link Lane Ft Co, CO 80524 494-7632
Contractor Address Qty/State Zipp Phone
Allen Service 1015 link lane Ft Co, CO 80524 484-4841
Contractor City of Ft Collins Sales Tax Are you paying taxes here or by report? ❑ jiere ❑ Report
sarestarmmde 1SnWrmadayaamrmacrars Are you paying with your trust a¢ount? VYes ❑ No
10010
Is this a residential or qpmmerdal project? tResidential ❑ Commercial
If residential, is it: '90 Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hobel/Motel ❑ Medical ofrum ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? O Yes 0 No If}Es, you nWnwartoconiactHftdcPreserratrarr
If this is for a demolition permit, what year was the building constructed?
Description of work P9OYC Ming fi 'm wW rcpl=nith like � t�
*If lawn sprinlderftcldtow meventer, must list Ramsed plumber. If first-time A/C, must list licensed electrician.
subcontractors•. Llstthecamp ,7a►rreorOWofltCarimAbmw#
EleMdari Pfumbef Mechanfo Roofer Other
I hereby acknowiedge that I have read this applimtion 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 buikfing construction. I know that a
permit is not valid until it has been paid and issued.
Applicant: Cjw7(WLrta Evavr6
Print Name: Signature Date
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