HomeMy WebLinkAbout842 Juniper Ln - Applications/Air Conditioner - 07/28/2014FROM :NCR
FAX NO. :9702299983 Jul. 28 2014 10:44AM P7/10
F6NOCothns
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fort Collins, 00 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). VAir Conditioning
d Demolition (Interior non-structural) ❑ Electrical Alteration (not service change) Cl Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler Q Mobile Home replacement ❑ Roofing Q Sewer Line Q Photo -voltaic
❑ Ventilation 17 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 #�j ��' Date .
For oASce use only
Sob Site' Address (required) Value of Construction (labor, materials, profit)
Property Owner Name ' Address City/State ZIP Phone
Applicant Name Address city/State Zip Phone
Contractor Address City/State F+(: li Zip Phone cf"Yo
or+h ���D A'ir the �l Ls��, Air' Co 49§t2-43
Contractor City of Ft. Collins Sales Tax d Are you paying taxes here or by report? ere ❑ Report
Saks tmrumacrtrrMdrndbyall cw&aaors. Are you paying with your trust account? �Ves' ❑ No
Is this a residentlal or mmercial project? IrResidential 0 Commercial
If residential, Is It. gi single Family Detached Q Condo/townhome (single family attached) El Duplex
Multifamily (apartment) ❑ Garage
If commercial, is It: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office I❑ Office ❑ Retail
❑ Restaurant ❑ Other (explai )
Is this building SO years Of age or more? O YesNo tfyes, you may need t>, contact Historic Preservation
If this is for a demolition permit, what year was �► a building constructed?
If prior to 197s, you W11 need an asbestos assessment to submit with this applk'aHon.
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or city Of Collins license 0
FJeciridan 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.
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