HomeMy WebLinkAbout2663 Sunstone Dr - Applications/Air Conditioner - 08/07/2014From:
08/07/2014 06:59 0251 P.001/001
City 0f Planning, Development & Transportation
/ For` Collins Fort Co I ns, C0Ave 80524 P.O. Box 580
�•— 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). )rAir Conditioning
❑ Demolition (interior non-structural) O Electrical Alteration (not service change) ❑ Gas Lighter O Gas Log
❑ Heating Unit O Lawn Sprinkler O Mobile Home replacement O Roofing 0 Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line O Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable information on the application.
Application # �T Q �1
For office use only
Incomplete applications will not be accepted.
Date 81-1yg
Is this a residential or commercial project? 4PResidential O Commercial
If residential, is it: ❑ Single Family Detached O Condo/townhome (single family attached) O Duplex
❑ Multifamily (apartrnent) ❑ Garage
If commercial, is it: ❑ Bank O Bar O Church O Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? O 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 prior to 1975, you will need an asbestos assessment to submit with this application.
Description of work
*If lawn sprinkler/backnow preventer, must list licensed plumber. If first-time NC, must list licensed electrician.
Subcontractors: List the company name or Gty of R 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:
Print Name:�rw, Signature,__��n . �.r.c�_ Date��y