HomeMy WebLinkAbout3018 Carrington Cir - Applications/Air Conditioner - 05/21/2014MAY/21/2014/WED 09:18 AM Delta Mechanical Inc FAX No,866-692-5275 P,002/002
Foirt of
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
17 Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater 0 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 # 01 �14 3(01(9 0Z Date � 21 I
Por office use only
Job Site Address (requ' ed)
value of Construction (labor, materials, profit)
3a
# 040
do
Proqerty Owner NamO
KW V4utff
Address
City/State
A. r� d4 I)ens OD
Zip Phone
W 652t5" 970-689=539
Applicant Name
Address
City/State
Zip
Phone
0
aIOW
' 51
6 ontract
0101
Addre City/State
(DSb i~ aline M 1'�lESq AZ
Zip
g5AOIo
Phone
$hb 02 5z75
hant l
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
IeHere ❑ Report
Sales tax number isrequlredb ARCO
cxors.
Are you paying with your trust account?
�"Ses El No
Is this a residential or co mercial project? ,M Residential ❑ Commercial
If residential, Is it., Ingle Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar 0 Church ❑ Hotel/Motel El Medical office ❑ office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes Ao If yes, you may need to contact Historic Preservabron
If this is for a demolition permit, what year was the building constructed?
Ifpnor to ?975, you w///need an asbestos assessment to submit with this appl/cadon.
Description of work ae 1?i ,� n
13. er I?drldtn.sp r
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first tttim, A,/C, u li icen el clan, A (%
Subcontractors, 4stOemmpanynameorratyofFtCollins license
.0 L�,'�/d vo =ram"'/�v
Electriaar. Plumber Mechanics iy 4/2'7 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 Nam