Loading...
HomeMy WebLinkAbout110 Frey Ave - Applications/Water Heater - 03/21/2018Application # -a «U For mice use or* Fort Coffins Qtypf Planning, Development & TransporitaHon 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) © Gas Lighter 0 Gas log ❑ Heating Unit O Lem Sprinkler Q Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic ❑ Ventilation 04 Water Heater ❑ Water Line ❑ Wood/pellet Stove (must be EPA certified, provide make, model and manufacturer). Complete all applicable fnbrmatlon on the application. Incomplete applications will not be accepted. Date 03/21/2018 o1z, I If, Is this a residential or commercial project? ® Residential ❑ Commercial If residential, is it: 13 Single Family Detached ❑ Cando/townhome (single family attached) ❑ Duplex ❑ Mulbfamily (apartment) ❑ Garage If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ HoW/Motel 13 Medical office ❑ Office ❑ Retail ❑ Restaurant ❑ Other (explain) Is this building 50 years of age or more? O Yes ❑ No Af AS, YOU may need M C0n1,-rdHW*or1rP&gserwb(on If this Is for a demolition permit, what year was the building constructed? Ifpwr to 1975, you will need an ads amesm"ent to submit wltft this application. Description of work k A 4 L;.,el 2 tv tin k t-cd.t *If lawn sprinkler/backnow preventer, must list licensed plumber. If first-time A/C, must list licensed elan. Subcontractors: List the =pany narrre or aly of R Collins license # Electrician Plumt Mechanical hoofer 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 building construction. I know that a Permit is not valid until It has been paid and ksued. ApplicantJeff Gallagher print Name: Signature Jeff Gallagher Date 03/21/2018