HomeMy WebLinkAbout601 Lupine Dr - Applications/Water Heater - 04/10/20202.
1. Job site address:
601 Lupine Drive
2. Property owner name:
William Anderson
3. Property owner address:
Street Address: : 2012 Cheshire St.
City:: Fort Collins
State:: Coloraco
Zip:: 80526
4. Property owner phone number:
970-488-0164
5. Project type:
Residential
6. What type of residential?
Single Family Detached
7. Value of work (Labor and Materials)($):
$1,403.00
B. Type of permit:
Plumbing
9. Scope of work:
Other Plumbing Work
10. Describe other plumbing work:
change out 40 gallon water heater
11. Master plumber or excavation company name:
Patrick Plumbing and Heating LLC
12. Master plumber or excavation company address:
3600 Horsetooth Court, Fort Collins
13. Master plumber or excavation company phone number:
970-566-1926
14. Master plumber or excavation company email:
pph2500@comcast.net
15. License number:
MP254
16. Additional information if applicable:
Change out 40 gallon natural gas water heater.
3. Review
17.1 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.
Signature of: Michael Patrick
Date Signed:
04/09/2020
16. Please include an email address to receive a confirmation and a copy of your answers.
pph2500@comcast.net
4. Thank You!
Thank you for submitting your application for processing.
To submit another over the counter application, click here.