HomeMy WebLinkAbout2931 Garrett Dr - Applications/Air Conditioner - 04/12/2013From:Poudre Valley Air 9704932073
04/10/2013 13:12 #150 P.001/003
Fort Cothns
Planning, Development & Transportation
281 N. College'Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
This application is to be used to apply for the following permits only (check all that apply). Cpir Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photc-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 # 2) 140 1 (P c9S
For office use only
Date y��c,1�3 Lf'f a -
Job Site Address (required)
Value of Construction (labor, materials, profit)
O\
Property Owner Name Address
City/State Zip
Phone
14
-
- 3
Applicant Name Address
City/State Zip
Phone
Contractor Address
City/state Zip
Phone
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report? ❑ Here
9 Report
Sales tax number,sregtorsdbyall mn&actors
Are you paying with your trust account? 9Yes
Q No
Is this a residential or commercial project7 EKesidential ❑ Commercial
If residential, Is it: mgle Family Detached ❑ Condo/townhbme (single family attached) ❑ Duplex
rMultifamlly (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes ❑ No ffyes, you may need to contact Historic preservation
If this Is for a demolition permit, what year was the building constricted?
If prior to 1975, you will need an asbestos assessment to submit wI(fi this application.
Description of work
*If lawn sprinkler/bacidlow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors:LL&t dre company name or Lily of Ft Collins Incense #
Electrician M\`f\ R\_ZX(lq_i'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:
Print Name: —Signature,,�y g, . - �� Date