HomeMy WebLinkAbout450 CIRCLE DR - APPLICATIONS - 6/20/2014 (2)Jun 20 2014 11:40AM Gary Hooley Heat and Air 9702249198
page 2
fort Collins
Planning, Development &Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
OVER-THE-COUNTER PERMITS ONLY
This applicatlon is to be used to apply for the following permits only (check all that apply). M Air Conditioning
❑ Demolition (interior non-structural) O Electrical Alteration (not service change) 0 Gas Lighter 0 Gas Log
M Heating Unit 0 Lawn Sprinkler ❑ Mobile Home replacement 0 Roofing ❑ Sewer Line ❑ Photo -voltaic
O Ventilation 0 Water heater 0 Water line M Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applieabla information on the application. Incomplete applications will not be accepted.
Application # C71O32AL pate 6/2017014
For ofi9ce use a,* a
Job Site Address (requ ftw)
Value of Construction (labor, matedals, profit)
450 Circle Drive
fife-% , 00
Property Owner Name Address
Oty/S'tate ZIp
Phone
Tyler Stampfii 450 Circle Drive
Fort Collins, CO 80524
412-3456
Applicant Name Address
City/State Zip
Phone
Tyler Stampfli 450 Circle Drive
Fort Collins, CO 80524
412-3456
Contractor Address
Cfty/State Zip
Phone
Gary Holley Heating & Air 1314 Webster Avenue
Fort Collins, CO 80524
493-3272
Contractor City of FL Collins Sales Tax #
Are you paying taxes here or by report?
® Here 0 Report
Saktstaxrwn*arisrPrz*adbyataw adoms
Are you paying with your trust account?
M Yes 0 No
34734
Is this a residential or commercial project? M Residential C Commercial
If residenttial, Is IC m Single Family Detached 9 Cmdoltownhome (single family attached) Q Duplex
O Multifamily (apartment) 17 Garage
Tcommercial, Is It: G Bank Q Bar 0 Church ® Hotel/Model O Medical office O Ofice Q Retail
O Restaurant O Other (explain)
Is this building 50 years of age or more? O Yes O No Ifyes, yrou may need to contact Nbsto& Pmsrivation
If this Is for a demolition ponnit, what year was the building constructed?
Ifp 7hr to 1975, you wNneed an asbestos assessment to subm/t vWb4 this appAstlon.
Description of work 1pstaiiipa 1.5 ton condensing unh
*If lawn sprinkler(bacidiow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractoma Lat 6e cnmpmWname orG7ty arm abhz s a2yase o
SWrician Creekside Plumber Mechanical H-1654 Roofer Otter
I hereby acknowledge that I have read this application and state that the above ir-formatlon 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.
Applicant
tNam Shell Swanson
Print Name: Y Signatures; Bate 1 _