HomeMy WebLinkAbout508 JANSEN DR - APPLICATIONS - 10/28/2013Oct28 1307:41a Swan Heating and Air 970-613-0826 p.1
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Planift&DevalWment&Transpo ftftn
2& N. Wfte Ave P.O. Box WO
Fort Collins, CA W524
Phone 9701F16-2740 R= 224.6134
OVER-THE-COUNTER PERMS ONLY
This application is to be used to apply tar the following Permits only (check all that apply). E3 Air Conditioning
Q n (interior non-emwturag t3 Bectncal Alteration (notservice change) ❑ Gas Lighter ❑ Gas Log
Eq(b sting knit II Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo-voltale
0 Ventilation ❑ Water Heater ❑ 11Uater l me ❑ WoodiFellet Stave (must be EPA certified, provide make, model and
manufecbnTar)L
Gonm ate all spolkable bdiormadon cn the OPPIleagoru. Incornolefe applications will not be accepted.
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Applimnt ftne Address
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COnhacbor City of OL Collins SidesTax #
Are you paying tmres here or by report
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Is this aresi 1, 11 t or omn pMe� Lp'�dential 0 GomrneruId
F residerrti* is W N=FtFamily Detached a Cardoftownhome (single family attached) t3 Dulft
a Mulsfamity (apartment) ❑ Garage
IFoommer W, is it E3 Bank ❑ Bar ❑ Church ❑ F oWft totes }3 MaW office ❑ office Q Retail
f1 Restuant ❑ Other (explain)
'Is t hwz building tap Years of age or morel U Yes o Ifyes you mayneed to contact hbtwfcPrraoaatlmi
if this is fora derridlillen Parnilik What Year was the building constructed?
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*#lawn sp►inkler/baddkw pravermr, waist list lialmd pkirraw. lfflrstiirree Ar, must list I[eatused eleciddan.
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I hereby admowiedge that I have read tills appiloaon and state that the above tafiar rmtton is aomplate and carrel I agree to
comply
ly hall�dWIN it lays been paid regei an maardh ul. ms and sffie laws ng mguMi>vifding oorustudk= I knwothat e