HomeMy WebLinkAbout1020 MONTVIEW RD - APPLICATION - 9/21/2021Cityof ):ort Collins
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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# __________ _
Date Received
ALL information is REQUIRED. Incomplete applications will not be accepted.
Job Site Address . _/.
Address / a ;_;2 d ~,?;1// C-t0
Property 0wn?r lnfo',f"atio'l / /'"' /
Name W(hf..,cl Y fl {A.AA L( ec_ V<
Address (oc? j r/1'w,,,z/v;-&.J J2J ,
Scope of Work
.)8:Air Conditioner
>9--Furnace
0 Minisplit
OBoiler
3.
4. ------~···--
0 Water Heater
Oother
5.
6.
; ···········-----··· .. ·-·--------------------+------
7.
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Company
License Holder.S--f J'c A@' 7
License Number II }7f' l,
Electrical Contractor Inf ation (only required for new installs)
Company License Number ME-___________ _
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
OYes
OYes
QNo
QNo
Equipment is same footprint or smaller O Yes
Equipment is same height or smaller O Yes
QNo
ONo
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 ________________________ _