HomeMy WebLinkAbout800 Sandy Cove Ln - Applications/Plumbing - 03/22/2017Mar 23 17 12:00p Hahn plumbing
970-493-5325 p.1
Crf
F6�rt Coffins
Piannin9r Development iL Transportation
281 N. Coliege Ave P.Q. Box Sao
Port Coffins, CO 805,24
Phone 970-415-274o Fax 224-6134
®E'ER q HE-00- UIPME-21 PURMR73 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 senrice change) ❑ Gas Ughtar ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler O Mobile Home replacement ❑ Roofing to Sewer Line . CJ Phobo-voltaic
C1 Ventilation ❑ Water Heater Rater line ❑ WoodlPellet Stove (must be EPA certified, provide make, model and
manufacturer).
Completa all applicable Information on the application- incomplete applications will no* be accepted.
Application >r_ I O 15?jrj Date
i`ar017 re use a*
Job ddmss
806 e A�� t'�4�d% 1�7G Q �� � Value of Construction (labor, materials, profit) 6 —
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Property Owner Name Address Gty/State Zip . • Phone
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Appticarr me Address City/State ZIP �} Phone
'+ Y 1 i ; ►'14 1 Ji> C 77l-6e.T • ► r ' c7 D �� q4t — J
Contractor Address City/state ZIP Phone
Contractor City of Ft Collins Tax # rnP— /S Are you paying taxes here or by report? O Here ;;Report
I sans = number Is requrred by all c=d=Wrs Are you paying with your trust account? g Yes ❑ Na
I r/) ') •� r;
is this a residential or merdal project? Lesidentlal ❑ Commerdal
if residential, is it single Famlly seta ed ❑ Condo/townhome (single family attached) • ❑ Duplex
Mu Mmily (apartment) ❑ Garage
If commercial, is It ❑ Bank ❑ Sar ❑ Church ❑ Hotel/Motel ID Medical office ❑ Cffiice iJ P.etatl
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? 17 Yes ❑ No 1fyas, you mayneed to contiaHistoric Araservabon
If this is for a demolition permit, what year was the building constructed?
it prior to 3475, you PAY need an astestas assessment is submit with this app/rcayen.
Description of work 1�P�1 Af , 1� \ 1 i . � r nn n P Y'
cif fawn sprinider/bedciiow preveriter, mutt Iist liremed plumber. If first fte A/C, mush list licu sed eledrlpan.
Subcontractors.. List MeaompanyrlomeorGiyofFcCD&Arjicerise�
SECClidan Plumber. Mechanical Roofer
Other
1 nera0y acknowledge that I have read this application and state that the above lnfomlation Is complete and Correct, i agree to
Comply with all requirements contained herein and city ordinances and state laws regulating building constr c n, i tmow that a
permit Is not valid until it has been paid and issued.
Applicant. lu
Print NameOLSlgnatur Date a