HomeMy WebLinkAbout221 E Swallow Rd - Applications/Water Heater - 05/07/2019city ofPlanning, Development, & Transportation Services
W Fort lim Community Development & Neighborhood Services
281 North College Avenue
Fort Collins, CO 80524 Main: 970.4162740 Fax 970.224.6134
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 ,Q Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilations ater Heater ❑ Water Line ❑ Wooff ellet Stove (must be EPA certified, provide make, model and
manufacturery.
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application # &K R q
Faratirco tw only
Date May 7.2019
lob Site Address (requited) Value of construction (labor, materials, profit)
221 E Swallow Road, Fort Collins, CO 80525 $3200.00
Property Owner Flame Address city/State 7Jp Phone
Arthur/Sarah Bragg 221 E Swallow Road Ft Collins, CO 80525 720-413-0548
Applicant Name Address City/state Zip Phone
Christina Evans 1015 Link Lane Ft Co, CO 80524 494-7632
Contractor Address City(State 7-:pp Phone
Allen Service 1015 Link lane Ft Co, CO 80524 4844-4841
Contractor City of FL Collins Sales Tax # Are you paying taxes here or by report? ❑Mere ❑ Report
sides taarnw7bertsmrpa edbya9wahado s Are you paying with your trust account? IWYes ❑ No
10010
Is this a residential or gimmercial project? Residential ❑ Cammercial
If residential, is it: 'V Single Family Detached ❑ Cmdo/townhome (single fam0yr attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it.. ❑ Bank ❑ Bar ❑ Church ❑ Hotelfttel ❑ Medical office El Office ❑ Retail
❑ Restaurant U Other (explain)
Is this building 50 years of age or more? ❑ Yes ❑ No Yyat!, you niaynwd to contact tfisft* PnesermWan
If this is for a demolition permit, what year was the building constructed?
Description of vuork Pp cosfln9.M awl Ml `With nil, like "'h
*If lawn sprinider/baddlow presenter, must list licensed plumber. If first-time A/C, must list licensed electrician.
subcontractors: WdiecamWmynameorGlyafftaffw #
Plumber Nedhantcat Roder Othher
I hereby acknowledge that I have read this application and st to that the above information is complete and correct I agree to
comply with all requirements contained herein and City ordinances and state laws regulating budding construction. I know that a
permit is not valid unbl it has been paid and issued.
Pn'nt Name: Chrt%tuuiEvcrxta Signature ft( W illy. 000,pa,. E/7'1t
Rwslmndate MO 17