HomeMy WebLinkAbout706 Mcgraw Cir - Applications/Air Conditioner - 08/20/2012h
Fort 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
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ 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 # hlb�S4 cw zo Date O ZZ01 2
For oAEe use only
Sob Site Address (required) Value of Construction (labor, materials, profit)
706 /#c �7mw Ci r Lod 411"1,9,5 foCX $ SP 3 5-7 - �U
Property Owner Name Address
City/State Zip
Phone
`7C>(o G r' CIy
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Applicant Name Address
City/State Zip
Phone
V f 3 PO'rvlVoS.e by Pev'4 �l���IS $05z!0 ?/V .2 -.
Contractor Lic # Address
City/State Zip
Phone
A46y'- -If H' iY9
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
Here ❑ Report
Sales tax number is required by all contractors
Are you paying with your trust account?
❑ Yes 64No
Is this a residential or cgrhmercial project? ❑' Residential ❑ Commercial
If residential, is it: 15 Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (expla)
Is this building 50 years of age or more? ❑ Yes Iff No If yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
If prior to 1975, you will need an asbestos assessment to submit with this application.
Description of work A& 16 Rif c�.G2�'�t e Pi
*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 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: Ja 50 ✓) 6
Si M'^ Date 2 D 2 v/ 2
Print Name: gnature