HomeMy WebLinkAbout836 Rumford Ln - Applications/Air Conditioner - 11/16/2015NOV-12-2015 00:28AM FROM -
9704048354 T-766 P.004/004 F-401
of
F4ft Collins
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). 2Air 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 accepter /'� Q l g
Application # ��� J� Date 1 �- �V D �`Q
For ofte use only
lob Site Address (squired)
Value of Construction (labor, materials, profit)
836 Rumford Ln.
$3,279
Property Owner Name Address
City/State Zip
Phone
Ann Ric ards 836 Rumford Ln.
Ft. Collins CO 80525
970
391-2130
Applicant Name Address
City/State Zip
Phone
Fort Collins Heating grid A or 209 Commerce Dr.
#4 Fort Collins, Co 5
Contractor Address
city/State Zip
Phone
Fort Collins Heating and Air 20R Commerce Dr. #4 Fort Collins CO 80524
970
484-4552
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
❑ Here
❑ Report
-Wes tax number®dradbyall wnpeCtovs
Are you paying with your trust account?
Q Yes
❑ No
Is this a residential or commercial project? IN Residential ❑ Commercial
If residential, is it: t3 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
13 Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes ❑ No If yes,. you may need to contact Histor/c Preservation
If this is for a demolition permit, what year was the building constructed?
Ifprlor to i975, you will need an asbestos assessment to subm/t with this application.
Description of work install AC replacement
*If lawn sprinkler/baddlow preventer, must list licensed plumber, If first-time A/C, must list licensed electrician.
Subcorrtractors. List the company name or City of Pt Collins license rP
eectidan 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 game; Angela Morrow Signature
Data 11/12/2015