HomeMy WebLinkAbout3719 Carrington Rd - Applications/Furnace - 02/17/2017From 9702299983 1.970.229.9983 Fri Feb 17 11:06:19 2017 MST Page 2 of 3
FROM : FAX NO.
Feb. 17 2016 06:03PM P2i3
Fort Collins
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
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) 0 Gas Lighter 0 Gas Log
O Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line M 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 # W UD1 I V
For office use only
Date 02/17/2017
lob Site Address (required) Value of Construction (labor, materials, profit)
3719 CARRINGTON RD $39045.00
Property Owner Name Address City/State Zip Phone
KEN BAAB 3719 CARRINGTON RD, FORT COLLINS CO 80525 970-225-9303
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 # . Are you paying taxes here or by report? O Here ❑ Report
Sales tax numberlsreWredby all Cuntr0do s, Are you paying with your trust account? fit Yes ❑ No
26862
Is this a residential or commercial project? El Residential ❑ Commercial
If residential, Is it: 0 Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) 13 Garage
If commercial, is it: 13 Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office O Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? O Yes ®No If ye5, you may need 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 applicallon.
Description of work REPLACE FURNACE 95%
*If lawn sprinkler/badcflow preventer, must list licensed plumber, If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or City of R Collins license 0
tlectriclan Plumber, Mechanical 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 bulkling construction. I know that a
permit is not valid until it has been paid and issued.
Applicant: KARENA
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Print Name: RENA.HUNTWORK signature HUNTwORK oa x pate 02/17/2017 __