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HomeMy WebLinkAbout3407 Stover St - Applications/Furnace - 06/25/2018of Fort Collins Planning, Development & Transportation 281 N College Ave P 0 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 ❑ Gas Log ❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo voltaic ❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified provide make model and manufacturer) Complete all applicable information onthe application Incomplete applications will not be accepted ((g Application # 6 1 O 0 Date 06/25/2018 For office use only Job Site Address (required) Value of Construction (labor materials profit) 3407 STOVER ST #G712 $2,465 00 Property Owner Name Address City/State Zip Phone MICHELLE RIESEL 3407 STOVER ST #G712 FTC CO 80525 970-412-5958 Applicant Name Address City/State Zip Phone Contractor Address City/State Zip Phone NORTHERN COLORADO AIR INC 812 STOCKTON AVE FT COLLINS CO 80524 970-223-8873 Contractor City of Ft Collins Sales Tax # Are you paying taxes here or by report? ❑ Here ❑ Report Sales tax number is required by all contractors Are you paying with your trust account? 0 Yes ❑ No 26862 Is this a residential or commercial project? ❑ Residential ❑ Commercial If residential is it ❑ Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex ❑ Multifamily (apartment) ❑ 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 0 No 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 REPLACE FURNACE 80% *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 bcense # Electrician Plumber. Mechanical Roofer 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 issued ApplicantKARENA " " Print Name KARENA HUNTWORK Signature HUNTWORK , - p" �"� Date 06/25/2018