HomeMy WebLinkAbout4436 CRAIG DR - APPLICATIONS - 7/16/2014Jun 18 2014 05:12PM One Hour Heating & Air 9706634097
page 3
City, of
ort Collins
This application Is to be used
❑ Demolition (interior non-struc
❑ Heating Unit ❑ Lawn SprinN
❑ Ventilation ❑ Water Heater
manufacturer).
Complete all applicable inforn
Application # K
For ofte use
Planning, Det elopment l& Transportation
281 N. College We P.O. Box 560
Fort Collins, CC 80524
Phone 970-416 2740 Fax 224-6134
THE -COUNTER PERM ONLY
apply for the following permits only (chec all that apply). El Air Conditioning
al) ❑ Electrical Alteration (not service Chang ❑ Gas Lighter ❑ Gas Log
❑ Mobile Home replacement ❑ Roofing Sewer Line ❑ Photo -voltaic
Water Line ❑ Wood/Pellet Stove (must be E A certified, provide make, model and
on the application. Incomplete applicaltions will not be accepted.
Date
Sob Site Address (required)
Value of Con
ruction (labor, materials, profit)
4436 Craig Drive
$-1
0
Property Owner Name
Address
city/State
Zip
Phone
Andre Kuzmenko
4436 Craig Drive
Fort Collins, CO80526
970-225-1153
Applicant Name
i Address
City/State
Zip
Phone
One Hour Heating & Air
'487 Denver Avenue
Loveland, CO
80537
970-663-4002
Contractor
Address
City/State
Zip
Phone
One Hour Heating & Air
487 Denver Avenue
Loveland, CO
80537
970-663-4002
Contractor City of Ft. Collins Sale
Tax #
Are you paying taxes h
re or by report?
® Here ❑ Report
.Salestax numberlsrrquliedbya#can trz
ctors
Are you paying with yo
ir trust account?
M Yes ❑ No
Is this a residential or commercial
If residential, is it: 10 Single Fa
❑ Multifamil
If commercial, Is It: ❑ Bank ❑
❑ Restaurar
Is this building 50 years of age
If this is for a demolition permtl
If prior to 1975, you wi//need an
roject? El Residential ❑ Commercial
ily Detached ❑ Condo/townhome (single fai
(apartment) ❑ Garage
lar ❑ Church ❑ HotelJMotel ❑ Medical offii
❑ Other (explain)
more? ❑ Yes ❑ No Ifyas yoummyneed
what year was the building constructed?
rbestos assessment to submit w/Lh this appl/cab
attached) ❑ Duplex
❑ Office ❑ Retail
cwtactH/stonc Preservation
Description of work Replace
90K
*If lawn sprinkler/backilow prevent II
Subcontractors: Ust the company
Electrician PlUrn
, must list licensed plumber. If find -time A/C, must
uame or Gty of Ft Colllns Ikense 0
Mechanical
list licensed electrician.
fer Other
i hereby acknowledge that I have re#d this application and state that the above Informal on is complete and correct. I agree to
comply with all requirements contal herein and city ordinances and state laws regula ng building construction. I know that a
permit is not valid until it has n paid and Issued. Applicant' Stacey Schmidt 5}A,,Q',
O6/18/2014
Print Name: signature Raba
t.