HomeMy WebLinkAbout2701 Stover St - Applications/Water Heater - 12/19/2019FCity of Planning, Development & Transportai7on Services
ord Collins Community Development & Neighborhood Services��— 281 North College Avenue
Fort Collins. CO80524 Main: 970.4162740Faic 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
13 Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
E3 Heating Unit 113 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 application. Incomplete applications will not be accepted.
Application #,
Date December 19, 2019
Job Site Address (regwrisq) Value of Construction (labor, materials, profit)
2701 Stover St #86, Ft Collins, Colorado 80525 $1859.00
Property Owner Name Address Gty/State Zip Phone
Ernestine Ervin 2701 Stover St #B6 Fort Collins, CO 80525 970-222-0633
Applicant Nance Address City/State zip Phone
Christina Evans 1015 Lurk Lane Ft Co, CO 80524 494-7632
Contractor Address Qty/Biala Zipp Phase
Allen Service 1015 Link Lane Ft Co, CO 805244 484-484I
Contractor City of Ft Collins Sales Tax # Are you paying taxes here or by report? ❑ ere ❑ Report
53�stazryar Bns7r6raarbya9mn6acfir� Are you paying with your trust account? Yes ❑ No
10010
Is this a residential or Wmmerclal project? Residential 13 Cnmmescial
If residential, is it V Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Muitifarnily (apartment) ❑ Garage
If commercial, !sit: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Mobel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes ❑ No If)w, ytru may need to mntartHstoik Pressrcradon
If this is for a demolition permit what year was the building constructed?
Description of work PiNn0°ed odstiry WM oa repwm,rtm like nil WM
*If lawn sprinkler/back how preventer, must list licensed plumber. If first-time A/C, must fist licensed electrician.
Subcontractors~LisMecamaanynameorCdyofFtCbMisiumase#
9ecAid Plumber Medhanicar Roofer Odrer
I hereby acknowledge that I have read this application and state that the above information is complete and tarred. 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.
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