HomeMy WebLinkAbout2061 Bennington Cir - Applications/Furnace - 02/27/2018City of planning, Development, & Transportation Services
Cofts Community Development a Neighborhood Services
281 North College Avenue
Fort Collins, CO 90524 Main: 970.415.2740 Fax 970 224 0134
OVER-THE-COUNTER PERMITS ONLY
This appilcalion to to be used to apply for the following permits only (cheek an that apply}. D Air Conditioning
O DemoGtron (Interior nwr*ucturaQ 0 Electrical Akeration (not service champs) D Gas Lighter El Gas Log
■ Heating Unit 13 Lawn Sprinkler O Mobile Home replacement O Rooting U Sewer Une 0 Photo-voltsic
13 Ventilation ❑ Water Heater 0 Water Une ❑ WoodlPellet Stove (must be EPA codified, provide make, model and
manufacturer).
Compiete all applicable Information on the application. Incomplete applications will not be accepted
Application # & RO QoZ,� l
ForaAloe use **
Date
]ob SrW Addross-(re0,re) Valaa�f Gsnstmexton (tabor, matatats, profit)
lftninnfn f irrl 0 3� 2;a
PropetY owner Name v _ Address
Applicant Name Address) aty/State zip Phone
Fort Collins Heading & Air 208 Commerce Dr. 94 Fort Collins, CO 80524 970.484.4552
CaltractOr Address aN/staw Zip Phone
Fort Collins Heating & Air 208 Commerce Dr. #4 Fort Collins, CO 60524 07n ARA dFs7
Contractor CItY Of Ft Collins Sales Tax d Are you paying taxes here or by report? ❑ Here r Report
SM"ftrnwter & nquw by arav ac&m f] Al O Are You paying wh your trust account? 0 Yes a No
Is this a residential or mormnedel project? ! ReIdentlal O Commercial
If residential, is R: ■ Single Fammilyy Detached 13 Condo/townhome (single family attained) 0 Duplex
0 MWftrfdly (apartment) 13 Garage
If eommerdal, Is It: O Bank 13 Bar 0 Church [3 Hotel/Motd O Medical d ice E3 Office t] Retal
O Restaurant O Oft (explain)
Is this building 50 Yeaxs Of age or more? 13 Yes ■ No jrf^MjMyneedbcwWHjftkpn5mjw
If this is for a demolition pen ft what year was the building construtbsi?
Description of work
u wwn apnnruerlDapelpw preventer, must est licensed plumber. V first-Adme A/C, must list tixarxacd elecbrixian.
Subconbactwsx List the o nWmynameorCity ofRCbnn$ kmog
Bedrum Ilumber. t H1309
Aoore Othe
I her* adawwledge that I have rind this appllamon and state that the above information Is eomplft and conett I agree tD
comply with all requirements contalhed herein and dtv ordinances and state laws regulating building fin. I know that a
permit Is not valid until It has been pail and Issued.
Appilo� c
Print Name. Signature Date —T 121,
RMtlmd1WZV M7