HomeMy WebLinkAbout1818 Ridgewood Rd - Applications/Mechanical - 09/09/2014SEP/09/2014/TUE 04:33 PM DELTA MECHANICAL -AZ FAX No,480-898-0005 P,002
Fort Collins
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 470-416-2740 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). it Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Light r ❑ Gas Log
'seating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo voltaic
❑ Ventilation d Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and EAmanufacturer). 1�` ,
Complete all applicable information on the application. Incomplete applications will not be accepted. `
Application # $140 $991 Date C1 � �
For oxce use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
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Property Owner Name
Address City/State Zip Phone �1
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Applicant rJame
Address City/State ZIP Phone TOT'
Address city/State Zip Phone $f ^.
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Contractor Gty of R. Collins Sales Tax
#� �� 07 GAre you paying taxes here or by report? ere ❑ Report
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Are you paying with your trust account? ❑ Yes �00
Is this a residential or c mercial project? J&2edIdential ❑ Commercial
If residential, is it: Wfngle Family Detach d ❑ Condo/townhome (single family attached) Cl Duplex
El Multifamily (apartment) ❑ Garage
If commercial, is it. ❑ Bank ❑ ear ❑ Church ❑ Hotel/Motel 0 Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (expla'
Is this building 50 years of age or more? ❑ Yes �JPfo Ifyes, you mayneed fo contadHiston'cpfasen ab°on
If this is for a demolition permit, what year was a urlding constructed?
Ifpr/or to 1975, you will need an asbestras assessment to submit with this application.
Description of work laze .9
*If lawn sprinkler/baci low preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List ME campmy name or 62y of Pt Collins dcense 0
decaicran Plumber Mechanical Roofer Other
I hereby acknowledge that I have read this application and state that the above Information is complete and wrrecL 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: C
Print Name• Signature
Date