Loading...
HomeMy WebLinkAbout1816 Orchard Pl - Applications/Mechanical - 07/08/2015FROM :NCR FAX NO. :9702299983 Jul. 07 2015 06:44AM P4/4 Fort Colhns Planning, Development & Transportation 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). ja Air Conditioning ❑ Demolition (interior non-structural) Cl Electrical Alteration (not service change) ❑ Gas Lights( ❑ Gas Log ❑ 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. Incomplete applications will not be accepted. Application # Ju Date '74. jJ For office use only Sob Site Address ( uired) Value of Construction (labor, materials, profit) to Lip ©f el _ Property Owner Name Address City/State Zip ��-I Phone 2 � e _.,. Applicant Name Address City/State Zip Phone Contractory Address City/State IC}CO %kCZip Phone Of`lb or+h din CAI cm> �ln � . `ai 2-s Go 4r 2,4 an Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? JKlere ❑ Report salesraxnumber/srequlredayallcontractors. Are you paying with your trust account? es ❑ No Is this a residential or c mercial project? jzf Residential O Commercial If residential, is it: Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex ❑ Multifamily (apartment) 0 Garage If commercial, is it: ❑ Bank ❑ Bar 13 Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail ❑ Restaurant 0 other (e2bullding ) — Is this building 50 years of age or more? ❑ yeso rf yes, you may need to contact HIstorlc Preservation If this is for a demolition permit, what year was constructed? if prior to t975, you will need an asbestos assessment to submit with this appl/cadon. Description of work *If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician. Subcontractors: List the company name or City of Ft Collins llrense fi Electricians Plurnber 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 Data +)LS