HomeMy WebLinkAbout3307 S College Ave - Applications/Mechanical - 11/03/201411 pay-- lob -L
Planning, Development & Transportation
City of 281 N. College Ave P.O. Box 580
F6rt 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). ❑ Air Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing Q 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. Incomplete applications will not be accepted.
Application # ��5003�5 Date
For white use only
Job Site Address (requfiedJ
Value of Construction (labor, materials, profit)
Property Owner Name
Address
G /State Zip
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Phone IbD3
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Applicantame
Address
city/State Zip
Phone
Contractor
Address
City/State P}C0(k1Y1CZip
Phone Cl11M
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Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report? JKlere ❑ Report
Saks tax number isrequredbyammntracrors
ngi-na
Are you paying with your trust account? es
❑ No
Is this a residential or commercial project? ❑ Residential RJ Commercial
If residential, is it: ❑ Single Family Detached ❑ Condo/fownhome (single family attached) ❑ Duplex
❑ 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? I] Yes M No Ifyes, you mayneed to conradNistmicPreservation
If this is for a demolition permit, what year was the building constructed?
If prior to 1975, you will need an asbestos assessment to submit with this appliradon.
Description of work
*If lawn sprinkler/backilow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: Wthe company name or City ofRCollins license #
Electridan Y t lumber Mechanlcal 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 1
Community Development & Neighborhood Services OCLvb2
GAY of.� 281 North College Avenue T Q
/ .0hns Fort Collins, CO
80524
70 416.2740
S
over the counter Qermit info sheet for. -
New and r v - - v eq "p , a "
The following
1. Roof -top e
X"'Re
i E
E
sU
equipment.
:eplacement 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 Neater:
❑ 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 " !d in compliance with 2009 IMC, IFGC, IPC, and
Applicant signat r and date
(Form updated 1-18-2013)