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HomeMy WebLinkAbout945 RIDGE RUNNER DR - APPLICATIONS - 6/5/2013Jun 0513 06:11 a Swan Heating and Air 970-613-0826 p.1 Planning, Development & Tranepor(ation 281 N. College Ave P.O. Sox 580 Fort Coll ins, CO 80524 Phone 970416-2740 Fax 224-6134 THE -COUNTER PERMITS ONLY OVER-THE-COUNTER �_,,CC This application is to be used to apply for the following permits only (check all that apply). "-r Condoning ❑ DdmoG6on (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log ❑ Heating Unit ❑ Lawn Sprinkler O Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic ❑ Ventilation ❑ Water Heater ❑ 1Nater Line ❑ Wood/Pellet Stove (must be EPA cefified, provide make. model and manufacturer). Complete all applicable information on the application. Incomplete applications will not be accepted. Application # Date ]ob Site Address (ragaired) value of constmwdon (tahor, maWT131s, profit) ,q1 Property OwneikName Address WState Zip Phone(&gC u e� 7� , ..Co )1i ns IPLM-CLo Applicant harne Ad WStabe Zip Phone Contradxx Address City/State Zip Phone q-76 c. r 41 0 5,-10 Contactor City of Ft Sales Tax # Are you paying taxes here or by report "t 13 Here . 12 �eport "eslax Invu w&m7effldbyaBm'Abradom Are you paying with your trust aomunt? lames ❑Igo is this a residential or com a1 project? idenrel ❑ Commerdal If residential, is 1W Single may Detached D CandD/fnwnhome (single fancy atladred) ❑ Duplex ❑ Muf6family (apanment) © Garage If Comrnar ial, is it: ❑ Bank ❑ Bar ❑ church ❑ Hotel/Motel ❑ Medical office ❑ Office E3 Retail ❑ Restaurant ❑ Other(explain) Is this building so years of age or more? ❑ Yes o rya'r, )vu may need to cofituthBtmfcPn ervatlov► If this is for a demolition PENTIft what Year was the builck g Constructed? Ifpzor lv 1975 yw wJNneed an at esWs mm-- nent &Pmdwxt Wffi M& apphtabba Desa"on of work *ff lawn sprin(der/baddiov+ preventer, narst III @oerrsed plumber_ if flrstfime AIC. must Gst Caernsed electrician. Subcontractors: Lfst me mmpan m me orGry oft t cwffns /lcrnse i` laPlwnw. Mechanical Roofer d I hereby admowiedge that I tame read this appr=dc n and state that the above information is complete and corned: I agree tD am,,* wRh all requirements gained herein and City ordinances and state laws regulating binding consbudian. I know tk t a permit Is not valid until it has been paid and issued. J / Ap Print Name: Y U e� Sigrtature`� 1 Date 1C1 5 �G u