HomeMy WebLinkAbout4512 BLUEFIN CT - APPLICATIONS - 12/12/2014Dec 1214 08:45a Swan Heating and Air
970-613-0826 p.2
CA
Fort Collins
OVER-TH
This application is to be used to apply for the €ol
❑ 17 olition (interior non-structural) ❑ Electrical A
Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ W
manufacturer).
Complete all applicable information on the applii
Application # T-I> 1 Sbbzao
For ofte use only
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970-416-2740 Fax 22+6134
ER PERMITS ONLY
permits only (check all that apply). Air Conditioning
i (not service change) ❑ Gas Lighter ❑ Gas Log
ment ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
let Stove (must be EPA certified, provide make, model and
Incomplete applications will not be accepted.
Date i�Q - 19
Job Site Address (required) I
Value of Construction (labor, materials, profit)
fG �5vO
Property Owner Name Address
City/State Zip Phone
- eb-.5 z
Appillant Name Address
i
I
City/State Zip Phone
Contractor Address
Gty/State Zip Phone
Contractor City of Collins Sates Tax #
Are you paying taxes here or by report? ED-Here ❑ Report
salesraxnumder&requiradbra#cw&aa=
Are you paying with your trust account? Q.Yw ❑ No
Is this a residential or commercial project? LW(tesid
If residential, is it: 0- gle Family Detached ❑
❑ Multifamily (apartment) ❑
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑
❑ Restaurant ❑ Other (expl
Is this building 50 years of age or more? ❑ Yes
If this is for a demolition permit, what year was the
Ifprior to 1975, you will need an asbestos assessment
Description of work
*If lawn sprinkler/baddlow preventer, must list licensed pluml
Subcontractors:UstMecompanynameorCity ofFtCoffins
Electrician Plumber Med
I hereby admowledge that I have read this application and
comply with all requirements contained herein and city ordi
permit is not valid until it has been paid and issued.
Applicant:
Print Nam,
❑ Commercial
ownhome (single family attached) ❑ Duplex
❑ Medical office ❑ Office ❑ Retail
If yes, you may need to contdrt Historic Presermbon
ig constructed?
rani` with ibis apprcabion.
If first-time A/C, must list licensed electrician.
W #
Roofer
Other
that the above information Is complete and correct. I agree to
s and state laws regulating building construction. I know that a
Date • c