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Home My WebLink About3903 Ridgeway Ct - Applications/Water Heater - 01/17/2017/ 17/2JRIr=77-ZU1T 11:d1PM PS&M_ TO : 19702246134. FROM: 710AY4915J34 T-428 1W004 t-841 C� �1'1lt eoe" Olanning, Development a Transportation FFortrt CO�tinS 3�D 1F �`riL7Jt� For N. College Ave P.O. Box 580 �j Collins, CO 80524 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 ❑ Gas Log ❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing 17 Sewer Line ❑ Photo -voltaic ❑ Ventilation ❑ Water Heater Cl 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. �l1 �)j � -� JAN 1.7 2017 Application # �-"� Date For ot)ae use only 3ob Site Address required) (rJ Value of ConS etion (labor, materials, profit) W Property Owite('(J Addr Ci sta Zip Phone 4 w 6borw 2 Applicant Name Ad ess Fort Cniling Heating and A 20R Commerce- I City/State Zip Phone Dr. #4 Fort Collins. CO 80524 (97"5-3478 Contractor Address city/State Zip Phone Fart Collins Heatine and Air 208 Commerce Dr. #4 Fort Collins CO 80524 970 4 4-4552 Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? ❑ Here ❑ Report salestarrwmberjFisW Wbya/lan&wbm Are you paying with your trust account? ❑ Yes ❑ No Is this a residential or commercial project? slig'Residential ❑ Commercial If residential, is it: ❑ Single Family Detached ❑ Condo/townhome (single family attached) O Duplex ❑ Multifamily (apartment) ❑ Garage If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ office ❑ Retail ❑ Restaurant ❑ Other (explain) Is this building 50 Years of age or more? D Yes ❑ No If yes, you may need to contact Hlstor/c Preservation If this is for a demolidon permit, what year was the building constructed? If prior to 1974 you MI/ need an asbestos assessment to subm/t with this application. Description of work *If lawn sprinkler/baddlow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician. 5ubeontrar-ors: List the company name or OW of Co//Irrs //tense # ©ecbidar— Plumber Mechanical H1309 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: PrinI1117 Print Name: Angela Morrow signature r/ (1 Date