HomeMy WebLinkAbout4512 BLUEFIN CT - APPLICATIONS - 12/12/2014 (2)Dec 12 1408:45a Swan Heating and Air
970-613-0826 p.2
FCiof
lirt Collins
OVER-THE-COU
This application is to be used to apply for the €ol
❑ D olition (interior non-structural) ❑ Electrical A
Beating Unit ❑ Lawn Sprinkler ❑ Mobile Home
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ W
manufacturer).
Complete all applicable information on the appli4
Application # 12>1500281
For ofte use only
Planning, Development & Transportation
281 N. College Ave P.O. Box 5B0
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
:R PERMITS ONLY
permits only (check all that apply). Air Conditioning
(not service change) ❑ Gas Lighter ❑ Gas Log
ment ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
Stove (must be EPA certified, provide make, model and
n. Incomplete applications will not be accepted.
Date
Job Site Address (required) I
Value of Construction (labor, materials, profit)
4 c Sr�rff�a
Property Owner Name Address
City/State Zip Phone
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Appli ant Name Address
i
City/State Zip Phone
Contractor Address I
city/State Zip Phone
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E�0S3B t
Contractor City of Collins Sales Tax #
Are you paying taxes here or by report? C,,1-ttere ❑ Report
Sales fax number isiequiredbyallaw&actam IAre
you paying with your trust account? ❑No
Is this a residential
If residential, is it
or commercial project? 2"Residenti;
13-5ingle Family Detached ❑ Con
❑ Multifamily (apartment) ❑ Gar.
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hob
❑ Restaurant ❑ Other (explain)
Is this building SO years of age or more? ❑ Yes M-tit
If this is for a demolition permit, what year was the buil
Ifprior to 1975, you will need an asbestos assessment to.
Description of work
*If lawn sprinkler/baddlow preventer, must list licensed pluml
Subcontractors: List Me companyname or City of Ft Collins
Electrician
I hereby acknowledge that I have read this application and
comply with all requirements contained herein and city ord
permit is not valid until it has been paid and issued.
ApplicarA-
Print Nam
❑ Commercial
ownhome (single family attached) ❑ Duplex
❑ Medical office ❑ Office ❑ Retail
If yes, you may need to contad-Htstonc Preser alion
ig constructed?
unit with dris application.
If first time A/C, must list licensed electrician.
se #
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