HomeMy WebLinkAbout2731 Jewelstone Ct - Applications/Furnace - 11/28/2016From 9702299983 1.970.229.9983 Mon Nov 28 16:53:17 2016 MST Page 2 of 2
FROM FAX NO. Nov. 28 2015 11:51PM P2/2
CRY of Planning, Development & Transportation
�' 281. N. College Ave P.O. Box 580
6r L}Collins Fort Collins, CO 80524
-k, 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) ❑ Electrical Alteration (not service change) ❑ Gas Lighter 0 Gas Log
El Heating Unit C1 Lawn Sprinkler ❑ Mobile Horne replacement l J Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation Q Water Heater Fl Water Line 0 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 11 /28/2016
For offirr^ use only
Job Site Address (mquirozy') Value of Construction (labor, materials, profit)
2731 JEWELSTONE CT $3,210.00
Property Owner Name Address City/State Zip
JENNIFER OLIVER 2731 JEWELSTONE, FTC CO 80525
Applicant Name
Phone
970-223-8098
Address City/State Zip Phone
Contractor Address City/State zip Phone
NORTHERN COLORADO AIR INC. 812 STOCKTON AVE, FT COLLINS CO 80524 970-223-8873
Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? 0 Here ❑ Reporl
Sales tax numberlsroq irwibyallconvacmrs. Are you paying with your trust account? ® Yes ❑ No
26862
Is this a residential or commercial project? ED Residential 0 Commercial
If residential, is it: 111 Single Family Detached ❑ Condo/townhome (single family attached) ❑ buplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: . ❑ Bank ❑ Bar 0 Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
0 Restaurant ❑ Other (explain)
Is this building So year a ur out: ui r i v, C? ❑ 'r'e5 m fVo J r yes, you play need to contact Historic PreserVotion
If this is for a demolition permit, what year was the building constructed?
If prior to 1975, you will need an a_sbestas ,7ssessrnent to submit with this application.
Description of work REPLACE FURNACE 95%
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the mmpany name or City of Ft collins 11cense #
Electrician , Plumber
Mechanical _. Roofer _
Other.
T hereby acknowledge that I have read this application and state that the above information is complete and correct. I agree to
rnr,nr,ly wihh Al rnrp.iiromunty contained heroin and city ordin mcco and mtotc low,' "Cgulating buddhiy -_V1IbhuLtlu11. I Know mai a
permit is not valid until it has been paid and issued.
Applicant: KARENA
Print Name: KARENA HUNTWORK_. Signature HUNTWORK
i'J ,-vMPu. o,pryrCfM a w
Date 10/27/2016
i •M J).y "i