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HomeMy WebLinkAbout2226 Bar Harbor Dr - Applications/Air Conditioner - 07/16/2014City of Planning, Development & Transportation Ort Cot tins 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), p Air C�onditloning O Demolition (interior non-stnacturai) C7 ©ectrical Alteration (not service change) ❑ Gag l lgt q 4 Gas Log ❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing e Sewer s ❑Photo voltaic ❑ Ventilation ❑Water Neater Cl VLbt� Line ❑ 4bbod/Pellet Stove (must be EPA curdled, provide make, model and manufacturer). Complete all applicable information on the application. Incomplete applications will not be accepted. Application # 4012-ArDate _ I t _ _ I z� Avr o tar on& W ]ob Site Address (iPqul ed) � Value of Con3 ct;o (I(I bon materials, profit Property Owner Name Address City/State AppIIG nt Name , / Address City/State �Ctf��D�C�rrlrr��rcea,L�r� � C C d'GtS� � 9�• �ho Contractor p/7 Address zipr�n Phone Contractor City of Ft. CollinY7i}'1 �- Saes rarnvii0s Sales Tax # Are you paying ❑ taxes here or by report? Here ❑ Report �� byalicw,tn�crwa Are you paying with your trust account? ❑ Yes ❑ No Is this a residential or Co�y� ercial project? residential ❑ Commercial If residential, is It: �-5ingle Family Detached ❑ Condo/townhome (single family attached) C] Duplex 13 Multifamily a If commercial, Is it: ❑ BankC7 ger ❑ Church ❑ Note%Motel ❑ Medical office L office [3 Retail 13 Restaurant ❑ other (explain) Is this building 50 years of age or more? O Yes ❑ No Ifyvs, you Me? IRWto o0lrtacth/3( If this Is for a demolition permit, what year was the building constructed? Pservatron Irp"or to 19&, POU W 1 neW On assbestbs 4SMY77ent to st rnit With t/ris applicatlon. Description of work *If lawn sprinkler/bacW0w preventer, must list licensed plumber. If first-time A/C, must list licensed electrician, . Subeontractorsc list file c"panY name or ob, of ft Cbldns /ke )se # Electridanw � Plumber ��� ---��_ Med�anical Roofer other I hereby acknowledge that I have read this application and state that the above information ig complete and correct, I agree to comply with all requirements contained herein and city ordinances and state la regulating building construction. I knew that a Penn! W not.val untie it has been paid and Issued, s regulating Print Name. �C� Slgnatu Date �� /�