HomeMy WebLinkAbout1006 Cuerto Ln - Applications/Furnace - 01/19/2017From 9702299983 1.970.229.9983 Thu Jan 19 11:04:18 2017 MST Page 1 of 2
FROM FAX NO. Jan. 19 2016 06:02PM PI/2
CityOf Planning, Development 8t Transportation
} 281 N. College Ave P.O. Box 580
Fort Collins Fort 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
O Heating Unit ❑ Lawn Sprinkler U Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ 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 # 2)M025
For ofte use only
Job Site Address (requ/red)
I J006 CUERTO LN #B
Date 01/19/2017
Value of Construction (labor, materials, profit)
$1, 592.50
Property Owner Name Address City/State Zip Phone
BOUTILIER CUERTO LLC 10566 STABLEHAND DR, CINCINNATI OH 45242 513-646-9953
Applicant Name 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 #
Sales tax number is requ/rer> Gy all wntracrom..
26862
Are you paying taxes here or by report? 01 Here ❑ Report
Are you paying with your trust account? 8 Yes ❑ No
Is this a residential or commercial project? O Residential ❑ Commercial
If residential, is it: ❑ Single Family Detached GI Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant 11 Other (explain) ._
is this building 50 years of age or more? ❑ Yes ® No If yes, you may nerd to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
If prior to 1975, you will need an asbestos assessment to submit with this application.
Description of work REPLACE FURNACE 80%
*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 ' MO(hdnical 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: KARENA
oHln Name: KARENA HUNTWORK signature HUNTWORK Date 01/19/2017