HomeMy WebLinkAbout3807 Benthaven St - Applications/Furnace - 01/17/2020FliCity os�,�1 p/arming, Development & Transportation Services
rt WlinS Community Development & Neighborhood Services
281 North College Avenue
Fort Collins. CO80524 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
❑ emolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo-voltdc
❑ Ventilation ❑ Water Heater ❑ Water Line i] 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 i ,
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Date January 16, 2020
Sob Site Add(mgWmd) Value of Construction (labor, materials, profit)
3807 Benthaven Street, Ft Collins, Colorado 80526 $5602.00
Property Owner Name Address city/State Zip Phone
William Gardiner 3807 Benthaven Street Fort Collins, CO 80526 602-819-4833
Applicant Name Address City/State Zip Phone
Christina Evans 1015 Link Lane Ft Co, CO 80524 494-7632
Contractor Address City/Siate Zrp Phone
Allen Service 1015 Link Lane Ft Co, CO 80514 484-4841
Contractor City of FL Collins Sales Tax Are you paying taxes here or by report? ❑Mere ❑ Report
star mrs fsrevrmtryaffconbarmAre you paying With your trust account? Yes ❑ No
10010
Is this a residential or Sipnmercial project? Resldentiai ❑ Commercial
If residential, is it M Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Mulhian y (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this budding So years of age or mane? ❑ Yes ❑ No Ifye.5, yiw rrraynead to cmitactHi hvkPresB7ation
If this is for a dernoGtion permit, what year was the building constructed?
Description of Work R0,ed vashng Furnace and replace with Me new R r w
*If lawn sprinlder/baddiow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: W t he wu4wnyname or0yafFtC ffwhrmrse #
@earidan Pltanber Medhaniral Raab Other
i hereby admowledge that 1 have read this application and state that the above information is complete and coned. I agree to
comply with all requirements contained herein and city ordinances and state laws regulating budding coristruction. I know that a
permit is not valid until it has been paid and issued.
Print
Applicant: Clwi�tfrtwEvan4 ch /tm 1l 16OIZDW-
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