HomeMy WebLinkAbout2825 Dundee Ct - Applications/Gas - Log, Line, Pipe - 02/22/2017 (2)i14.42-
Fort of
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 ning
Demolition (interior non-structural) Electrical Alteration (not service change) Gas Lighter Gas Log
Heating Unit Lawn Sprinkler Mobile Home replacement Roofing Sewer Line Photo- laic
manufacturer).
Ventilation Water Heater Water Line Wood/Pellet Stove (must be EPA certified, provide make, model and
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application #_ � r � � Date
For office use only
Is this a residential or commercial project? Residential Commercial
If residential, is it: �irtgt ami y e ac on o/townhome (single family attached) Duplex
Mu ti amr ent) 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 If yes, 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 application.
Description of work
0
*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 �— Mechanical
Roofer Other
1 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 notvalid until it has been paid and issued.
Applicant:
Print Name:Signature U as
Date
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