HomeMy WebLinkAbout820 Merganser Dr - Applications/Water Heater - 03/23/201894
In
Church Signs
pli mt "M Darelopment 8L T rartsporbMan
Of �1 i 281 N. College Ave P.O. 8mc 00
t Colli1'y s I;at CoMm, CO M24
Phone 970-416-2740 Fax 22+6134
OVER-THE-COUNTER PERMITS ONLY
6/3P7. 9'32 AM
setlon is to be used to apply for the fbilowfng permfts only (chat* all that apply). 13 Air Conditioning
on (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
Unit ❑ lawn Sprinider O Mobile Home repent ❑ Roofing O Sewer Line ❑ Phoba-voltsic
on dA'Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
ai applicable information on the application. Incomplete applications will not be accepted.
Date - 3 Z3� 18
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S7e Address &egL*W) value of tbnstru (tabor, maberiats, profit)
ic
�^ `' 5575�i C CttYlstate Y P Bib[ I I Phone6?7 C
11r tt Marine Address City/State Zip � 33 If
,4" /i-1f4 57PUe Aa 126
tractor i///i?r 14A,1 N pie Address awstate ZIP/ 3
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r>tractor C&y of Ft. Collins Sales Tax #aj 006 Are you paying taxes here or by report? 0 Here A --Port
Are you paying wOyour trust account?.QYes ❑Nio
is dds a residents or commercial project? XResidential E3 Commercial
Ifresiderdal, is It. 'Single. Family oetathed f] Condo/townhome (single family attadied) ❑ Duplmc
❑ Multifamily (apartment) 13 Garage
If conwwrdaL is Jr 0 Bank D Bar 13 Church 13 Hotel/Motel 13 Mediml office O office O Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? O Yes ONO IPye* you mayneed m con&&HA & PhweniW r
If this is for a demotion permit, what year was the building constructed?
1 prior to 197s, you W need an asbastas aaseoaent cv submit Kft dW agWaWOn.
of wmrk
lawn siorinlder/baddiow prevenber, must lid rice sed Plumber. If fast -time A/C, must list licensed electrician.
List die =panyname orQYy ofR Co5vNcer e #
Plumber = MedSardcal Rooter
I adavAledge that I have read this appIIotlon and state that the above Infformation is complete and correct I agm to
with ati regWremerns cortarned herein and dty ordinances and state laws reguledng building congUuc ion. I know flint a .
is not valid uWA it bans been Frain and tasued.
Data
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