HomeMy WebLinkAbout612 MORSMAN DR - APPLICATIONS - 5/30/2012 (2)City of planning, Development &Transportation
�,-�rt CQIUns FartCollege sos24 P.O. Box sso
Phone 970-416-2740 Fax 224.6134
OVER-THE-COUNTER PERMITS ONLY
This application is to be used to apply for the following permits only (check all that apply). 0 Air Conditioning
CJ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) D Gas Lighter ❑ Gas Log
M Heating Unit D Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line O Photo -voltaic
D Ventilation O Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable Information on the application. Incomplete applications will not be accepted.
Application # 120 3326 Date May 30, 2012
Fior ofte use only
Job Site Address (rmqulred)
value of Construction (labor, materials, profit)
612 Morsman
$2448.00
Property Owner Name
Address
City/state
zip
Phone
Carol Hargadine
612 Morsman
Fort Collins
80526
631-9109
Applicant Name
Address
CIty/State
Zip
Phone
Carol Hargadine _
612 Morsman
Fort Collins
80526
631.9109
Contractor
Address
city/state
Zip
phone
Gary Hooley Heating & Air
1314 Webster Ave
Fort Collins
80524
493-3272
Contractor City of Ft Collins Sales Tax # Are you paying taxes here or by report? O Here M Report
Sa/er O'nvmbera M%&L d bya#mntr a&s Ar
34734 a you paying with your trust account? d Yes G No
Is this a residential cw Commerdal project? 8 Residential C Commercial
If residential, is it: M single Family Detached ® Condo/townhome (single family attached) . ❑ Duplex
13 Multifamily (apartment) ❑ Garage
If commercial, is R7 0 Bank 13 Bar ❑ Church Q HoteVMotel 0 Medical office G Office ❑ Retail
13 Restaurant C3 Other (explain)
Is this building So years of age or more? Dyes ❑ No Ifyea, you may need to contact Nlstolic Pcrsrrvar/on
If this Is for a demolition permit, what yezr was the building constructed?
D`pc'ior to 1975, you w1# need an asbPstus assessment to submit with th/s appllr2tion.
Description of work
*If lawn sprinkler/backtlow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors,- List trie company name or City of Ft Collins lkwzse .0
6octrtd3n -,: Plumher -
Mechanical H-1654 Refer Other
1 nay "*nMedge 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.
Apptllcant Sheryl Johnson
PMgt,Name; rY
64� WIN
Date 2>
2/2'd t72T9 b22 0Z6:01 80Tit722016 1,3000H:w0Jd 22:2T 21:02-02-1,HW