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HomeMy WebLinkAbout3018 Milner Ct - Applications/Furnace - 04/01/2019atyof D F6rt Colleens planning, oeuelopment & TiransWtaticen 281 N. College Ave P.O. Box 580 Fort Collins, CO 80524 Phone 970-416-2740 Fax 224-6134 OVER= 'H -COUNTER PEMM ONLY This application is to be used to apply for the following permits only (check all that apply❑Air oning ElDlition (interior non-structural) ❑ Electrical Alteration (not service change) ❑Gas Lightee r ❑Gas Log LLog Heatiemong Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic ❑ Ventilation Owater Heater ❑ Water Line 0 WoodlPellet Stove (must be EPA certified, provide make, model and manufacturer). Complete all app i able information on the application. Incomplete applications will not be accepted. Application # OW (`q IS For office use only ?roperty Owner Name' _ aa?ss pplicant Name II Address Con c` r Address )j -ilt�5 U d LLc- �( Contractor City of Ft. Collins Sales T x # Sates tax number is required by a// conbactors Date value of Construction (labor, materials, profit) City/State Zip Phone Zip n Phone Zip Phone Are you paying taxes here or by report? ❑ Here rI Report Are you paying with your trust account? 9 Yes ❑ No is this a residential orromercial project? P4 Residential ❑ CommercialIf residential,is it: ngle Family Detached❑ Condo/townhome (single family attached)❑Duplex ultifamily (apartment) ❑ Garage If commercial, is it: ❑ Bank ® Bar ❑ Church ❑ Hotel/Motel M Medical office ❑ Office ❑ Retail ❑ Restaurant ❑ Other (explain) is This building ®years ©r age or more? ❑Yes No If yes, you may need to contact Historic Preservation if this is for a demolition permilt, what year was the building constructed? If prior to 1975, you will need an asbestos assessmentro submit with this application. Description of work *If lawn sprinkler/back low 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_m Plumber \ 7 91 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 pemit is not valid Until it has been paid and issued. % applicant: ` Date L Print Ka me: (i' h 1� gignaiure