HomeMy WebLinkAbout3125 Meadowlark Ave - Applications/Furnace - 08/14/201808/14/2018 2:17PM FAX 8704844373 00001/0001
Planning, Development & Transportation
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). 0 Air Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
AkH acing Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ve tilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
man acturer).
Coco lete all applicable fo (�ti n on the application. Incomplete applications will not be accepted.
Appl cation # Uv �) v v Date I 0
For ofte uss only
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ice Address frequiMaj3Jx5
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Crooner Name Address
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City/State ZIP Phone
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Appli:ant
Name Address
City/State Zip Phone
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Con
actor Address
City/State 2i Phone
Con
actor City of Ft. Collins ales Tax #
Are you paying taxes here or by report? ❑ Here *Report
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aes
Jr number Ismqu/redbyall mnovewrc
Are you paying with your trust account? J) Yes ❑ No
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Is this a residential or commercial project? Vilesidential ❑ Commercial
If residential, is it: &Single Family Detached ❑ Condo/townhome (single family attached) O Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office E3 Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? O Yes XNo If yes, you may need to contact Historic Preservation
If thif is for a demolition permit, what year was the building constructed?
If pnpr to 1975, you will need an asbestos assessment to submit with this applicadon.
of work
*If lawn sprinkler/backfiow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
List the company name or City of Ft Collins llciense 0
Plumber Mechanical Roofer Other
y acknowledge that I have read this application and state that the above Information Is complete and correct I agree to
with all requirements contained herein and city ordinances and state laws regulating building construction. I know that a
is not valid until it has been paid and issued.
Signature
Date O l ) 1 °