HomeMy WebLinkAbout3002 W Elizabeth St - Applications/Air Conditioner - 10/16/2015OCT-16-2016 11:45AM FROM-
9704848954 T-564 P.001/001 F-102
Cityt of
rColl�n5
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). ❑ 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 # B 150 7507- Date �d - I
For olifce use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
3002 W Elizabeth #2E
$3,042
Property Owner Name Address
City/State Zip
Phone
ri 01borne 973 W 124th Dr.
'Westminster, CO 80234
303 907-2394
Applicant Name Address
City/State Zip
Phone.
Fml Coiling Heating and Air 208 Commerce 1Dr.
#4 'Fort -Collins, CO 805')4
(970) 494-455-7
Contractor Address
City/state Zip
Phone
*Fgrt Collins Heating and Air 208 Commerce Dr. #4 'Fort Collins CO 80524
970 484-4552
Contractor City of Pt. Collins Sales Tax
Are you paying taxes here or by report?
❑ Here ❑ Report
Sales tax number is requiW by all [on&actors:
Are you paying with your trust account?
❑ Yes ❑ No
Is this a residential or commercial project? g Residential ❑ Commercial
If residential, is it: ZUinale Family Detached ❑ Ccndn/tnwnhnma (cinalP family attarhwl) 0 Duplwc
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building So years of age or more? ❑ Yes ❑ No If yes, you may need to contact Historic Preservat/on
If this is for a demolition permit, what year was the building constructed?
lfpn'or to 1975, you MI/need an asbestos assessment to submit with this application.
Description of work ac install
lawn sprinkler/backftow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subwntracbprs; list the company name orOtyofFtColllnslicense 0
Electrician 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.
Applicant:
Print Name: Angela Morrow signature
Date
10/16/2015