HomeMy WebLinkAbout6306 Falcon Ridge Ct - Applications/Air Conditioner - 08/22/2019Aug 21 2019 02:47PM Swan 9706130826
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Fort Collins
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 60524
Phone 970-416-2740 Fax 224-6134
OVER-THEoCOUNTER PERMITS ONLY
This application is to be used to apply for the following permits only, (check all that apply).
Air Conditioning ❑ Electrical Alteration ❑ Gas Lighter ElGas LogiHeating Unit ❑ Lawn Sprinkler
❑ Mobile Home replacement ❑ Sewer Line ❑ 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 # e vl Q(N ?2:0c Date
For office use only M71' `9A
Job Site Address (required)
Value of Construction(labor, materials, profit)
3(DLO '00
Property Owner Name Address City/State Zip Phone
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Applicant Name Address
Clty/State Zip Phone
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Contractor Address
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City/St to Zip Phone
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Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report? ❑ Here ❑ Report
Sales raxnamberisrequircdbyallcontractors.
Are you paying with your trust account? Yes ❑ No
Is this a residential or c mmercial project? Mtesidential ❑ Commercial
If residential, is it: JaSingle 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 ❑ No If yes, you mayneed to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
Of
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/Cr must list licensed electrician.
Subcontractors: List the company name or G1y of ft Collins license #
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: SSle 1Dslgnatu Date at `ol