HomeMy WebLinkAbout1635 Blue Spruce Dr - Applications/Mechanical - 12/09/2011City of fort Collins Building and Zoning Dept. P.O. Box 580 Fort Collins, CO 80522
Phone 970-221-6760 Fax 970-224-6134
City of Fort Collins OIIER,THE-COUNTER PERMITS ONLY
Use this application to apply for a permit for any of the following: (check all that apply),k air conditioning, ❑ demolition
(interior non-structural), 0 electrical alteration (not service change), 0 gas lighter, 0 gas line, ❑ gas log,)( heating Unit
0 lawn sprinkler, 0 mobile home replacement, ❑ roofing, ❑ sewer line, 0 ventilation, ❑ water heater, ❑ water line,
0 wood stove (*provide model name & number).
Complete all areas of the applications that are applicable to your permit request - Incomplete applications will not be
accepted. An over-the-counter permit will only be valid when it has been paid -In -full and issued.
Application # � � (�
Date
(for office unse onlly)
Prpperty Owner Name Address p Phone
�� ,oucPT-i,J CO. 363-�q�fil �l
Applicant Name Address Phone
;B e 1-4>vo
Contra cfipt Name City Ucc # �/�A�ddress Phone
�f !tiN `/l�I !'NS l�P�Gl.i• �"��lJ W AiiAi q Zr-5r-m. 4-g5_
v� f�'�/ yAie, 2
Contractor City of Ft. Collins sales tax # :�Q6:0�a Pay taxes here? ❑ Yes V No
Job Site A dress
I lo3S eve- SP oe pie
Value of Construction (labor, material, profit)
$ -7 q 7 q
Is this'a residential project? ❑ Yes ,'&L No
If residential Is it: O Single family detached ❑ Condofrownhome (single family attached)) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
Is this a commercial project? . )Yes ❑ No
If commercial is it: ❑ Bank ❑ Bar ❑ Church O Hotel/Motel X Medical Office ❑ Office ❑ Retail
Cl Restaurant ❑ Other(explain)
Is this building 50 years of age or more? ❑ Yes No
If yes, you may need to get historic preservation approval prior to permit issuance.
Description of WorKMU.Ce gLr -e- (R S i bA) KTU uW M 9. 0 0 t r
v / r /s CA PA tE >'f- /oo %°o 00TLboR A) 0- iN7?4 re
**If lawn sprinkler/backtlow preventer installation, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontra ors:(list the contractor company name or license #)
Electrical L&O IC Mechanical Plumbing Roofing Other
1NU. o
I hereby acknowledge that I have read this application and state that the above Informatlon Is correct and agree to comply with all
requirements contained herein and city ordinances and state laws regulating building construction.
Applicant: Q Q
Print Name (aD.D LA Signature&4 Date/"a
6 /Z #
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City, of Community Development & Neighborhood Services
Fort Collins Fort North CO 80Avenue
/0""' . 970.416.2740
. Over the counter Permit info sheet for. -
New and rep/acement hvac roof top equipment
The following information must be included on commercial/multi-family projects to approve
the permit.
1. The hvac equipment is:
'X Replacement of existing equipment.
❑ New/additional roof -top equipment.
2. For Replacement equipment:
f-� t I � � "'*Ir�i
;L Equipment is the same weight or lighter and similar or smaller size/footprint.
❑ Equipment is heavier and will provide engineered documentation showing roof can
support new equipment or modifications that must be done to support such
equipment.
❑ Replacement equipment is in the same location and not taller than .previous.
o Replacement equipment is in new location and/or taller.
3. For New equipment:
,o See attached engineered documentation showing roof can support new equipment
or modifications that must be done to support such equipment.
4. Is outside air (ventilation) being provided for building occupants through this hvac system
(see 2009 IMC chap 4)�How will equipment be set to meet this requirement? If not how
is ventilation provided? - A -
Ves ;v
�vT�oo2. A i2 s��x d"
&W3 "46 l2- -1
Applicant signature and date
(Farm updated 9-22-2010)
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'Wd99:60'�1-60-Z1