HomeMy WebLinkAbout400 Butch Cassidy Dr - Applications/Mechanical - 10/28/2011fort Collins
�VQR�THE COUNTER
Planning, Development & Transportation
281 Ni College.Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970-41&2740 Fax'224-6134
PERMITS ONLY
This. application Is to be used to apply for the following permits only (check all that apply).:0 Air Conditioning
❑ Demolition (interiornon-structural) ❑ Electrical Alteration (not service change) ❑ Gas1ighter 1] Gas Log
❑, Heating Unit ❑, Lawn Sprinkler ❑- Mobile Home replacement O Roofing, ❑� Sewer Line ❑ Phot'o-voltaic
0! Ventilation ❑ Water.Heater 0 Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide, make, modeland
manufacturer).
Complete all appliicfU
able Informationronnthe application: Incomplete applic tions Ill not be accepted. Application #2� � lY D Date
AoroffTce we only 1 (JW •1 I �-�( ��-4
Sob Site Addressesgil,
'1113
V lue of�Construction'(labor,:materials, pro t)
Property Ow er Name.
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Address
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City/S fe zi
Ph ne
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uSin
Octn�'a;n
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Applicant�Name
Address
city/State ap
Pho e
Q
Contractor
Address
Clty/State Zip
Phone
Air Comfort, Inc 150
Rome. Court
Fort Collins, CO 80,524
970-490-1458
Contractor City of ft. Collins Sales Tax # Are you. paying taxes �here:or by report?
C# Here ❑ Report
sal�astaxnrnber�s. ,iiedbyaumnhacror�
Are you paying with your trust account?
0 Yes ❑ No
31791
Is this a residential or commercial project? Wilesidential ❑-Commerdal
If residential, Is,it: C],$ngie�Famiiy Detached ❑ Condo/townhome (single family attached) 13 Duplex
NI'MUltifamily (apartment) ❑ Garage
If commercial, is it: El Bank ❑' Bar ❑Church E3 Hotel/Motel :❑ Medical office 'D Offlee 13 Retail
E Restaurant 0 Other (explain)
Is this building 50 years of age or more? ❑ Yes ❑ No if p% you jWyneed to contact NdoticPresecvadon
If this is for a demolition permit, what year was the building constructed?
1f prior too IV S, you will need an asbestos assessment to suborn Wth Oils a cplicetion•
Description of work
*If lawnsprinkler/,backflow,prevenber, must list licensed plumber..If;first-time A/C, must list licensed electrician.
Subcontractors: 41st dre counpanynatne or O'tyoflt Cblllns.lkense.
Secridan Plumber Mechanical H1321 Roofer Other
I hereby acknowledge that I'have read this:application andstate 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 itbas beempaid and Issued.
Q-57
Date
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9/0
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