HomeMy WebLinkAbout301 Smokey St - Applications/Mechanical - 08/06/2014Planning, Development &Transportation
City, Of 281 N. College Ave P.O. Box 580
FOI ` CollinslFort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
OVER-THE-COUNTER PERMITS ONLY
V42t;�
_�,;�3,25
This application is to be used to apply for the following permits only (check all that apply). W Air Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
/I Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑.Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make; model and
manufacturer).
Complete all applicable information on the application.
Application # (� S (,
For office use only
Incomplete applications will not be accepted.
Date W-4—
/ V
Job Site Address (required)
Value of Construction (labor, materials,,profit)
Property Owner Name
,S�.r.M; I � � IlV stmn S V
Address
06 f c1t1k vd r.
City/State
o�� �Ol��s
Zip
2S'
Phone
/D 3'77.
Applicant Name
Address
City/State
Zip
Phone
Contractor
00/)
Address
o� f f
City/State
f I11
Zip
DSZ_
Phone
z/5-�,r
Contract r City of 9t. Collins ales Tax #
Sales tax number is required by all contractors. Are you paying with your trust account? ❑Yes No
Is this a residential.or commercial project? ❑ Residential 'm Commercial
If residential, is it: ❑ Single Family Detached ❑ Condo/townhome (single family attached) ❑Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office JSI Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes 'q 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 subm/t with this application.
Description of
„k ,-4*<--
*If lawn sprinkler/baclflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: Llst the company name or City of Ft Collins license #
FJectridan 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 Nam
Signature
Date I 'V /
City of Community Development & Neighborhood Services
a ' 281 North College,Avenue ,
Flirt Collins Fort Collins, CO 80524
- 970.416.2740
Over the counter permit info sheet for. -
New and rep/acement hvac roof -top equipment, furnaces, and water
heaters
The following information must be included to approve the permit. Check all that apply.
1. Roof -top equipment and furnaces:
AReplacement of existing equipment.
❑ New/additional roof -top equipment.
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.
% Replacement equipment is in new location and/or taller.
/❑ For New equipment. See attached engineered documentation showing roof can
support new equipment or modifications that must be done to support such
equipment.
❑ Ground or floor mounted.
2. Hot Water Heater:
❑ Replacement
❑ New
❑ Same size or smaller than previous.
❑ Larger than previous water heater.
❑ If for a restaurant.I have approval from Larimer County Health Dept for minimum
water heater capacity.
3. All equipment/appliances must be installed in compliance with 20,12 IMC, IFGC, IPC, and
2014 NEC.
8
signatgfe and date
(Form updated 1-18-2013)