HomeMy WebLinkAbout312 Gordon St - Applications/Furnace - 12/23/2019Fort 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) 13 Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
O Heating Unit IM Lawn Sprinkler 17 Mobile Home replacement ❑ Roofing ❑ Sewer Line C3 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 application. Incomplete applications will not be accepted.
Application # 6 1 " ( �J q C14
For office use only
,; 3
Date 12/=1-12019
Job Site Address (requ/red)
Value of Construction (labor, materials, profit)
312 Gordon St.
$ 2851.00
Property Owner Name Address
City/State Zip
Phone
Christine Moore 312 Gordon St.
Fort Collins, CO 80521
231-4062
Applicant Name Address
City/State Zip
Phone
Darrow Clark 1314 Webster Avenue
Fort Collins, CO 80524
493-3272
Contractor Address
City/State Zip
Phone
DC Shortridge dba Gary Ha 1314 Webster Avenue
Fort Collins, CO 80524
493-3272
Contractor City of FL Collins Sales Tax #
Are you paying taxes here or by report?
O Here ❑ Report
Sales tax number®aredbyall con6actcrs
Are you paying with your trust account?
M Yes ❑ No
34734
Is this a residential or commercial project? 0 Residential O Commercial
If residential, is it G Single Family Detached 0 Condo/townhome (single famlly attached) B Duplex
C Multifamily (apartment) 11 Garage
If commercial, is it: ® Bank 9 Bar Cl Church 0 Hotel/Motel 0 Medical office 9 Office I] Retail
G Restaurant 0 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 W11 need an asbestos assessment to submit w1th this application.
Description of work Replacing fumace with an 80% efficient 90K BTU gas furnace
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: list Me company name or City of Ft Collins license #
Electrician Plumber MechanicalH-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. --�,�ry,q ,,, o„ l,o,
Dennis .ffl. o^ CNPo°°�°
Re°wn Ib.p.a P.M. ON.
Applicant Dennis Shortrid e ShOrtl Idge p 1p
9 ', 15 ,
Print Name: Signature Date _ 12/17/2019