HomeMy WebLinkAbout2424 Tamarac Dr - Applications/Electrical - 08/26/2015City Of running, uevesopmenc aL i ransporravion
281 N. College Ave P.O. Box 580
F6rt Collins
Fort Collins, CO 854
Phone 970-41616-2740Fax 2246134
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 ❑ 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 # is (50 (D 3 V
For ofce use only
Date
cc'-16 -ls
Job Site Address (required)
Value of Construction (labor, materials, profit)
2424 Tamarac Dr
$1500
Property Owner Name
Address
City/State Zip
Phone
Jake Whipple
2424 Tamarac Dr
Fort Collins, CO 80521
(970)227-8025
Applicant Name
Address
City/State Zip
Phone
Mike Stapp
2725 Spoke Ct
Fort Collins, CO 80521
(970)690-7022
Contractor
Address
City/State Zip
Phone
Kinnetic Electric
.S7.27 &e,, Pe U.
N-A Fort Collins, CO $05a 1�-
(970)310-7784
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
❑ Here ❑ Report
Sales tax number is required by all contractors.
Are you paying with your trust account?
❑ Yes ❑ No
Is this a residential or commercial project? 0 Residential ❑ 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 ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes M No If yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
If poor to 1975, you will need an asbestos assessment to submit with this application.
Description Of work We will be upgrading the service from 100A to 150A. Mike Hergenreder & Rob Irish have already
confirmed for us that the lines are there for a 150A service.
*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 license #
Electrician ME-1274 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.
r
Applicant: /
Print Name: Mike Stapp Signature Date 8/26/15