HomeMy WebLinkAbout3006 Placer Ct - Applications/Water Heater - 02/08/2017Feb 10 2000 07:44AM One Hour Heating & Air 9706634097
page 2
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Collins
Planning, Development lit Trani
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-61
OVER-THE-COUNTER PERMITS ONLY
This application Is to be used to apply for the following permits only (check all that apply). 13,
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) O Gas Lighter E
❑ Heating Unit 9 Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ElSewer Line ❑ Ph
❑ VentilationNater Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide
manufacturer).
Complete all applicable Information on the application. Incomplete applications will not be ac
Application # t 1100 519 Date
For office use only
it Conditioning
Gas Los
model and,
Job Site Address (fequired)
Value of Construction (labor, materials.
profit)
3006 Placer Court
$1,500.00
Property Owner Name Address
Clty/State Zip
Phone
Robi Callaghan 3006 Placer Court
Fort Collins, CO 80526
970-215-8326
Applicant Name Address
City/State Zip
Phone
One Hour Heating & Air 487 Denver Avenue
Loveland, CO 80537
970-292-5769
Contractor Address
City/State Zip
Phone
One Hour Heating & Air 487 Denver Avenue
Loveland, CO 80537
970-292-5769
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report? M I
lere ❑ Report
Sates tax numbwIsrega/redbya#convactas.
Are you paying with your trust account? EI
es ❑ No
Is this a residential or commercial project? M Residential ❑ Commercial
If residential, Is it: ® Single Family Detached ❑ Condo/townhome (single family attached) ❑ Du 31ex
❑ 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? ❑ Yes ❑ No Ifyes, )vu may need to contact Historfc Preas mffon
If this Is for a demolition permit, what year was the building oonstructed?
If pnor to 1975, you will need an asbestos assessment to submit with this application.
Description of work
r heater
*If lawn sprinkler/baddiow preventer, must list licensed plumber. If first-time A/C, must list licensed
Subcontractors: List bbe company name or try of ft Collins tkense f
Electrician Plumber Ben Franklin MedwNcai H-824 Roofer
I hereby acknowledge that I have read this application and state that the above information is complete and
comply with all requirements contained herein and city ordinances and state laws regulating building constru
permit Is not valid until It has been paid and Issued.
Applicants Stacey Schmidt S}����� sa
Print Name: Signature ��'"""y Date
t. I agree to
I know that a
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