HomeMy WebLinkAbout6102 Claire Ct - Applications/Furnace - 02/20/2020Planning, Development & Transportation
Fort Collins Fort N. College Ave P.O. Box 580
Collins,
CO 80524
Phone 970-41616-27402740 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 ❑ Electrical Alteration ❑ Gas Lighter ❑ Gas Log ❑ Heating Unit ❑ Lawn Sprinkler
❑ Mobile Home replacement ❑ Sewer Line ❑ 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 # 1*4 Date 2/12/20
For office use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
6102 Claire Court
$ l08 ao o 00
Property Owner Name Address
City/State Zip
Phone
Cheryl & Roger Reisig 6102 Claire Court, Fort Collins, CO 80525 USA
(970) 218-0835
Applicant Name Address
City/State Zip
Phone
fflaOctli'm Wtq 4600 Innovation Dr. Suite 102 FortCollins CO 80525
970-399-9940
Contractor Address
City/State Zip
Phone
Benjamin Franklin Plumbing 4600 Innovation Dr. Suite
102 Fort Collins, CO 80525
970-399-99
Contractor City of Ft. Collins Sales Tax #
Are y u-paying taxes here or by report?
❑ e Report
sales tax number is required by allconbacYnrs
you paying with your trust account?
Yes ❑ No
52310
Is this a residential or c mercial project? Residential ❑Commercial
If residential, is it: Single Family Detached ❑ Condo/ZtelO
e-(single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑YNo
Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (exp
Is this building 50 years of age or more? ❑ Yes If yes, you may need to contactHistoric Preservation
If this is for a demolition permit, what year was the building constructed?
Description of work U pI a GrC M4. i1+ I pai - w �p k BT m , o) 3 o/, G n G
NrV1, ih h&S,�_Ms,Mt
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or City of Ft Collins license #
Electrician Plumber.
Mechanical � -,3 8 3 01 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.
Applicant: M ,� �` l� /J 4O g ./�� 2/12/20
Print Name: ` I� Si nature / �(/ Date
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