HomeMy WebLinkAbout1705 HEATHERIDGE RD - APPLICATIONS - 9/22/2021 (3)Cityof
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Community Development and Neighborhood Services
281 N College buildingservices@fcgov.com
Fort Collins, CO 80524 970-416-2740
WATER HEATER & HVAC PERMIT
APPLICATION
Application# J,1-lfrt·( {73
Date Received 0\ • . 1 Q'l.,
ALL information is REQUIRED. Incomplete applications will not be accepted.
Job Site Address
Address 17(15 1-rr!f THE r2.. , D 'jC
Property Owner Information
Name J;/?/4)0Nc PRoP£t,'( rY\AiuA-GGm§'PT Phone Number __ °l_f0 __ -_Ll_'s_°l_-_'2_Z_7_S __ _
Address /Soc{ tu \)\)OSPsc 7 City/State/Zip For? C"oa,,., :, 5<'.'.J.53:'.'
Scope of Work
0 Air Conditioner
Jz)>turnace fc-le:1v/l.~ /5. 00 OL.))
~: L.., l'r:J£_~£_")7,'_•L~--------1--~+_o_o_-:_oo_······_·······--t····· -~gF~-~~±-
0 Minisplit
0Boiler
j?Ywater Heater
Oother
Contractor Information _ {\ \
Name~ l'-\1/\q'IV--U
4.
5.
6.
Company 'f/\S)...:,S S:5 -1-\fA,,-vC,
License Holder \\'A-S'\µ7 5 5 ·1-t E/\,, ,.__, (, License Number H I ?.:. ---'~~~------------
Electrical Contractor Information (only required for new installs)
Name-------------------------------------------
Company ___________________ _ License Number ME-___________ _
Rooftop O Yes O No Note For new rooftop equipment or replacements that are heavier than original, engineered documentation
needs to be provided to show roof can support equipment.
Equipment is same weight or lighter
Equipment is in same location
Location
0Yes
0Yes
0No
0No
Equipment is same footprint or smaller O Yes
Equipment is same height or smaller O Yes
QNo
0No
If for a water heater or boiler in any food or beverage serving facility/Day Care/Institution occupancies, I have approval from the
Larimer County Health Department for minimum water heater capacity. 0 Yes O No
Tenant Name ________________________ _
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.