HomeMy WebLinkAbout613 Lesser Dr - Applications/Furnace - 02/13/2017' / 7/ 2%70T_2UR8 RVIS STFROM_ TO: 19702246134
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Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
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 ❑ 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 #
lb 1-7 00 (o52
For ofike UW only
Date 2' / (3/ 1-7
Sob Site Address (nequlred)
Value of Construction (labor, materials, profit)
13 Lesser Dr.
$?-Iz95
.
rName 'Address
City/State Zip
Phone
T
Applicant Name Address
Fort CoUins Heating and Air IOR (eirritnerce
I City/State Zip
Dr. #4 Fort (,c)llinS- CO -80524
Phone
(970)'111715-147R
Contractor Address
City/State Zip
Phone
Fort Collins Heating and Air 208 Commerce Dr. #4 Fort Collins CO80524
970 484-4552
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
❑ Here ❑ Report
sale, &wnumberis reqWlEdbyaYcxvadm
Are you paying with your trust account?
❑ Yes ❑ No
Is this a residential or commercial project? hllaResidential ❑ Commercial
If residential, is it: Single Family Detached 0 Condo/townhome (single family attached) ❑ Duplex
O Multifamily (apartment) 17 Garage
If commercial, is it: O Bank 0 ear ❑ Church ❑ Hotel/Motel D Medical office ❑ Office ❑ Retail
O Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes ❑ No If yes, you may need to contact H/storic Preservation
If this is fora demolition permit, what year was the building constructed?
Ifpnhr to 1975, you will need an asks assessment to submit with this application.
Description of work
*If lawn sprinkler/baddlow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcont►actum: Ust the company name or Ldy of Co//ins license #
Electrician Plumber Mechanical H1309 Roofer
Other
I hereby admowledge 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:
Print Name: Angela Morrow Signature
Date>I CD1'r��r