HomeMy WebLinkAbout221 Lyons St - Applications/Furnace - 02/15/2017'/14/JFJ74-YU1T1�1':03PMPSFROMF TO:19702246134 FROM:71phV491434 T-600 pP. /00A 7-21A
Citty, of Planning, Development & Transportation
pPXmi4 +0 281 N. College Ave P.O. Box 580
Fort Collins U�e Fort Collins, CO 80524
horv(�,�,(%inQX 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 ❑ Sewer Line ❑ Photo -voltaic
U 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.
Application # Rj76073& Date 1 /I
For ot)ice use only
Sob Site Address (mquined)
Value of Construction (labor, materials, profit)
221 Lyons St.
$5,051
Property Owner Name Address
City/State Zip
Phone
Molly Mclaughlin/Zach Taylor 221 Lyons St
Fort Collins 80521
(706) 333-1649
Applicant Name Address
Fort Collim Heating and Air 208 Commerce I)r
City/State Zip
44 Fort Colling CO 80524
Phone
(970) 305-347R
Contractor Address
City/State Zip
Phone
Fort Collins Heatine and Air 208 Commerce Dr. #4 Fort Collins CO 80524
970 484-4552
Contractor City of R. Collins Sales Tax #
Are you paying taxes here or by report?
❑ Here ❑ Report
-Vestunwnber&repuaedbyall ron&aaom
Are you paying with your trust account?
❑ Yes ❑ No
Is this a residential or commercial project? 4RResidential ❑ Commercial
If residential, is it: I* Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant 13 Other (explain)
Is this building 50 years of age or more? O Yes ❑ No If yes, you may need to contact Historic Areservatlon
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
*If lawn sprinkler/backilow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or 0Y of Fr Collins license p
Flectridan Plumber Mechanical H1309 Roofer Other
I hereby acknowledge that 1 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
Data 2/19/1-7