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HomeMy WebLinkAbout3262 Bryce Dr - Applications/Air Conditioner - 03/10/2016MAR-10-2016 10:25AM FROM- 9704848354 T-571 P.001/002 F-564 �t Collins Planning, Development & Transportation 281 N. College Ave P.O. Box $80 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 O Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement O Roofing ❑ Sewer Line ❑ Photo -voltaic ❑ Ventilation ❑ Water Heater O 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. b1(00ilq&) _ Application #lln y Date `` . /o - l w rot o aw only Job Site Address (required) Value of Construction (labor, materials, profit) 3262 B1yce Dr. . 5 792 CPI &9 / / Property Owner Name Address City/State Zip Phone Tustin Lish 3262 Bryce Dr. Fort Collins CO 80525 970 371-5479 Applicant Name Address City/State Zip Phone Fort Callffins HCating and Air 209 Commerce DE, #4 Fort Colling, CO R0594 (270) 305-3479 Contractor Address City/State Zip Phone Fort Collins Heating and Air 208 Commerce Dr. #4 Fort C-oilins, CO 80524 970 484-4552 Contractor City of Ft.. Collins Sales Tax # Are you paying taxes here or by report? ❑ Here ❑ Report sa/estaxnwnbwlsrMulmabyallcmir&r0ns Are you paying with your trust account? ❑ Yes ❑ No Is this a residential or commercial project? ❑ Residential ❑ Commercial If residential, is it: C3 Single Family Detached El Condo/townhome (single family attached) ❑ Duplex ❑ Multifamily (apartment) © Garage If commercial, is it: ' [3 Bank ❑ Bar ❑ Church 17 Hotel/Motel O Medical office ❑ Office 13 Retail ❑ Restaurant' Q Other (explain) Is this building 50 years of age or,more? ❑ Yes ❑ No If yes, you may need to contact Historic Preservation If this is for a demolition permit, what year was the building constructed? Yprior to 1975, you will need an asbestos assessment to submit with this application. Description of work AC install x2 *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 AT Collins license 0 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: Angela Morrow Signature Date _ .! �a /