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HomeMy WebLinkAbout820 Merganser Dr - Applications/Water Heater - 12/14/2016Dec 29 16 08:10p Ellmann Service Co 9702233324 p.4 PlartrAngrDetrelopWkw8c7 1M F8�RI281 N. College Ave P.D. Box 5t30 Fort Collins, Ci3 8O524 Phone 970-416-274O Fax n46L34 AVER -THE- R PERME"N" ONUT This application Is to 6a used to apply for tits foliomrinB wMtts only (check all the apply). ❑ Air Corabning Cl Demolition (Interior nw"tr mural) : D ElecWcal Alteration (not service dhange) ❑ i3as Lighter D fts frog D Heatlng Unit ❑ Lawn Sprmider ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic 13 Ventilation ❑ Water Heater El Water Line0 Wood/Pellet Stove (must be EPA cartified, provide make, model and manttkdwal- Cornplet8 all aPPiica le information on the application. Incomplete applications will not be accepted. . Application # , _Il9(1'l-j4U /Z r-/IIT^ For ofike &w only ]ob Site Addms (regtaied1_.._, _ —.._.:: 2 Ls this a Mi5J or commerclal pit? WReslderidal Q Commercial If residential, is. rt 0Singla Famlly Detached ❑ Cordo/townhorre (single fem]ty aMwAed) C] Dupierc n©p t U commenxal, is kt ❑ Bankgar QQrurch O Hotel/Motel Q Medical Office 0 Office Q Retail - IS this 6u. _..._..._._❑.Resia[pdnt- ...13 Dther (explain). _... _. 9ding so yeas of age or more? O Yes `ONO -Ir this is fora. demolition permit, what year vmsthe-buDdingmnet�? �v edQ7 mntdctf t PrPs Ban anenttr7.�rb/nkr�Jthi;�app/kvCayz Description of work al IaWtl wo-werloa=aw P► wenter, must ft rcensed P�-r. If fhst-time A/C must Ast licensed ek bin. Subcwtlratt"M 1 dheccvnpeViyne�rlearC�yofft�ofiasdf�nas I hereby ad momedga that I have read && Wficetion and state that the above Information is comply with all rMWMMents contained herein and �, ominwMw and state laws ��S bvHdtn9 won. I complete and e . 12 agreetD permit Es sot valid occult it hes bow paid and Laced. tQ+ow that a Print P1ama• /f -2j �9eataa l 1 Date / 211 Yfl6