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HomeMy WebLinkAbout1632 Fantail Ct - Applications/Mechanical - 04/08/2015FROM :NCA FAX NO. :9702299983 Apr. 09 2015 03:16PM P2/3 Cit of Planning, Development & Transportation y 281 N. College Ave P.O. Box 580 Fort Collins 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)X-Air Conditioning Q pemolition (interior non-structural) ❑ Electrical Alteration (not service change) Q Gas Lighter ❑ Gas Leg Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic Ventilation ❑ Water Heater © Water Line Q 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 # --L::' For office use only Date �� �1�2 Job Site Address (required) a. Value of Construction (labor, materials, profit) Loo- PropertyOwner Name Address City/State ZIP Phone z a' Applicant Name Address City/State Zip Phone 1�i_� Contractor Address ' Gty/State kIlgCZ(p P o �}'D Contractor City of Ft. Collins Sales Tax >t Are you paying taxes here or by report? _*ere .*ere ❑ Report sales tax numLwrisregulredby$#canlractors aB'(�a _ Are you paying with your trust account? ❑ No Is this a residential or co erdal project? 01tesidential ❑ Commercial If residential, is It: Singie Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex ff Multifamily (apartment) ❑ Garage If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail ❑ Restaurant ❑ Other (explain) Is this building 50 years of age or more? ❑ Yes ATNo Ifyes, you may need to contact Historic Preservation If this is for a demolition permit, what year was the building constructed? If prior to 197Z you will need an asbestos assessment to submit with this appllcalion. Description of work *If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician. Subcontractors: Gist the company name or City ofi=tCo/linslicense # Electrician Plumber Merhanlcal 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 Date q —a O