HomeMy WebLinkAbout416 Stover St - Applications/Furnace - 03/15/2019City of
t C®Llins
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). ❑ Air Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
O 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 on the application.
Application #
S111 I D/ 15V1
For office use only
Incomplete applications will not be accepted.
Date 3/15/2019
Job Site Address (required)
Value of Construction (labor, materials, profit)
416 Stover St.
$ 1989.00
Property Owner Name Address
City/State Zip
Phone
RHT LLC 2731 GRANADA HILLS DR Fort Collins, CO 80525
493-3272
Applicant Name Address
City/State Zip
Phone
RHT LLC 2731 GRANADA HILLS DR Fort Collins, CO 80525
493-3272
Contractor Address
City/State Zip
Phone
DC Shortridge dba Gary Hil 1314 Webster Avenue
Fort Collins, CO 80524
493-3272
Contractor City of Ft Collins Sales Tax #
Are you paying taxes here or by report?
M Here ❑ Report
Sales tax number Is required by all contractors.
Are you paying with your trust account?
M Yes ❑ No
34734
Is this a residential or commercial project? W Residential ❑ Commercial
If residential, is it: M Single Family Detached 8 Condo/townhome (single family attached) 9 Duplex
❑ Multifamily (apartment) 13 Garage
If commercial, is it: 9 Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes ❑ No If yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
Ifjonor to 1975, you will need an asbestos assessment to submit with this application.
Description Of work _Replacing furnace with an 80% efficient 70K BTU gas furnace
*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 license #
Electrician Plumber Mechanical H-1654 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. oq;,,,,,,q e,„,pe,N;sS„o, ;,a,
Applicant:Dennis Shortridge
Print Name; Signature
Dennis 5 1®ge. E- a ea geMm wOm•ms
de a eBree to epecNeE pens o1Vvs
Shortridge ;,p;=„o�
Date
3/15/2019