HomeMy WebLinkAbout418 E Thunderbird Dr - Applications/Furnace - 01/08/2020Fort 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 application is to be used to apply for the following permits only (check all that apply).
❑ Air Conditioning ❑ Electrical Alteration ❑ Gas Lighter ❑ Gas Log ❑ Heating Unit ❑ Lawn Sprinkler
❑ Mobile Home replacement ❑ Sewer Line ❑ Ventilation ❑ 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 # �Z�� (
For office use only
Date 12/ 19 1Z2cg,)
-7-�
Job Site Address (required)
Value of Construction (labor, materials, profit)
418 East Thunderbird Drive
'A Cd 3 Lj a Ci 1
Property Owner Name Address
City/State Zip
Phone
Lee Howell 418 East Thunderbird
Drive, Fort Collins, CO 80525 USA
(970) 495-1748
Applicant Name Address
Citv/State Zip
Phone
M' 4600 Innovation Dr. Suite 102 Fort Collins CO 80525
970-399-9940
Contractor J M f }ICd F Jn • Address
City/State Zip
Phone
4600 Innovation Dr. Suite 102 Fort Collins, CO 80525
970-399-9940
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
❑ He Report
Sales tax number is required by all contractors
Ar •you paying with your trust account?
es ❑ No
52310
Is this a residential or copffiercial project? 13,kesidential ❑ Commercial
If residential, is it: Single Family Detached ❑ Condo=elO
ingle amily attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garag
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/ical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain
Is this building 50 years of age or more? ❑ Yes o If yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
Description of work
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or City of Ft Collins license #
Electrician Plumber Mechanical 14 � 2 3cl Roofer
Other
I hereby acknowledge 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.
Applicant:p 12/11/19
Print Nme: pASignature Date