HomeMy WebLinkAbout1655 Streamside Dr - Applications/Mechanical - 10/25/2013Oct 09 2013 04:07PM Albrachts One Hour 9706634097
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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 # 3 b 5 3 Date [• a S• 3
For oftice use only
lob Site Address (required)
Value of Construction (labor, materials, profit)
1655 Streamside Drive
$11,721.00
Property Owner Name
Address City/State Zip
Phone
Susan Gavaldon
1655 Streamside Drive Fort Collins, CO 80525
970-219-6046
Applicant Name
Address City/State Zip
Phone
Albrecht's One Hour Heating & Air
487 Denver Avenue Loveland, CO 80537
970-6634002
Contractor
Address City/State Zip
Phone
Albrecht's One Hour Heating & Air
487 Denver Avenue Loveland, CO 80537
970-663-4002
Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report?
❑ Here IN Report
Sales tax number& required by aucontractom Are you paying with your trust account?
® Yes ❑ No
Is this a residential or commercial project? 50 Residential ❑ Commercial
If residential, Is it: ® 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 (explain)
Is this building 50 years of age or more? ❑ Yes ❑ No If yes, you may need to contact Historic Preservation
If this Is for a demolition permit, what year was the building constructed?
If pnor to 1975, you will need an asbestos assessment to submit witfr this application.
Description of work Replace 115K BTU furnace, 5 ton AC and coil
*If lawn sprinkler/badcflow preventer, must list Ilcensed plumber. if first-time A/C, must list licensed electrician.
Subcontractors: List the company name or City of Ft Collins license #
Electrician Plumber Mechanical RocFer
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: Stacey Schmidt
Print Name: Signature
s sdae4*
Date 10/09/2013