HomeMy WebLinkAbout6927 Avondale Rd - Applications/Water Heater - 01/23/2020City of Planning, Development, & Transporpafion Services
Fort Collins Community Development & Neighborhood Services
281 North College Avenue
Fort Collins, CO 80524 Main: 970.4162740 Fax 970224.6134
OVER-THE-COUNTER PERMITS ONLY
This application is to be used to apply for the following permits only (check all that applyj. ❑ Air Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating U Lam Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation Water Heater I] 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 January 21, 2020
Job Site Address (&quhred) Value of Construction (labor, materials, profit)
6927 Avondale Road, Ft Collins, Colorado 80525 $4750.00
Property Owner Name Address City/date 7Jp Phone
baniel Hamp 6927 Avondale Fort Collins, CO 80525 970-430-6447
Applicant Name Address City/State Tip Phone
Christina Evans 1015 Link Lane Ft Co, CO 80524 494-7632
Contractor Address Oty/State 7.rpp Phone
Allen Service 101 S Link Lane Ft Co, CO 80524 484-484I
Contradnr City of Ft. Collins Sales Tax # Are you paying taxes here or by report? ❑ ere ❑ Report
sift tar xzbffIsr p&adbya#ar t dam Are you paying with your trust account? IWYes ❑ No
10010
IS this a residential or �mmercial project? Regdentia( ❑ Commercial
If residential, is it: V Single Family Detached ❑ Condo/tnwnhome (Single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Mobel ❑ Medical office ❑ Of -roe ❑ Retail
❑ Restaurant ❑ Other (explain)
is this building So years of age or more? ❑ Yes ❑ No Yp esy you mayneed tv cvntattHatnrlc Preservetron
If this is for a demolition permit, what year was the buUding ooristructed?
Description of work hew odstrg wnr as rep$=wth o taldn -m
*If lawn sprinkler/baddiow preventer, must list licensed plumber. it` first-time AJC, must list licensed electrician.
Subcontractors- testtlrecoaWWnamearrRyofftCoRnsAbmw#
eedwan plumber medhanic2i Rooter Other
r hereby admowledge that I have read this apprrotion and state that the above information is complete and correct i agree bD
comply with all requirements contained herein and city ordinances and state taws regulating building construction. I know that a
pernut is not valid until it has been paid and issued.
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