HomeMy WebLinkAbout1020 Cunningham Dr - Applications/Air Conditioner - 09/03/2019City of Planning, Development, $ Transportation Services
F6rt Collins Community Development & Neighborhood Services
281 North College Avenue
Fort Collins, CO 80524 Main: 970.416.2740 Fax: 970.224.6134
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 # �1 7094C3
For office use only
Date 9/3/19
Job Site Address (required) Value of Construction (labor, materials, profit)
1020 Cunningham Dr. #2 3641.09
Property Owner Name Address City/State Zip Phone
Jaordan Vase 1020 Cunninghan #2 FOrt Cillins, CO 80526 7209995658
Applicant Name Address City/State Zip Phone
Fort Collins Heating & Air 208 Commerce Drive #4 Fort Collins,CO 80524 9704844552
Contractor Address City/State Zip Phone
Fort Collins Heating & Air 208 Commerce Drive #4 Fort Collins,CO 80524 9704844552
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
31906
Is this a residential or commercial project? ® 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 ❑ No Ifyes, you mayneed to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
Description Of work replace air conditioner
*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 Plumber Mechanical H1309 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: Amanda Elder Signature Amanda Elder Date 9/3/19
Revision date 2/6/2017