HomeMy WebLinkAbout5974 Snowy Plover Ct - Applications/Air Conditioner - 04/27/2016APR-27-2016 03:47PM FROM-
9704848354 T-006 P.001/001 F-512
c'rf`t Coitins
MMO-- ,4
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 Q 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 # `5I to Sal . Date
For ofbe use only
Job Site Address (Mqulmd)
Value of Construction (labor, materials, profit)
5q2q Snocu l
w'1,6Z5
Property Owner Name Address
City/State Zip
Phone
YA
' S' er 5 y nacu
laves f . jrZ ? 237- 270
ApplicaAt Nami Address
City/State Zip
Phone
Conbacbor Address
City/state Zip
Phone
Fort Collins Heatin and Air 208 Commerce Dr. 44 Fort Collins CO 80524 970
484-4552
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report? ❑ Here
❑ Report
&tstaw numberisrequired bya//contractws
Are you paying with your trust account? ❑ Yes
❑ No
Is this a residential or commercial project? 10 Residential ❑ Commercial
If residential, is it: 111'Single Family Detached 0 Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is It: [] Bank O Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ office ❑ Retail
0 Restaurant ❑ Other (explain)
Is this building 50 years of age or more? EiYes ❑ No If yes, you may need to contact Histo c Preservation
If this is for a demoliition permit, what year was the building constructed?
IfpNor to 1975, yvu W# need an asbestos assessment to submit with this application.
Description of work
*If lawn sprinkler/backklow 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 9
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. 1t know that a
permit is not valid until it has been paid and issued.
Applicant:
Print Name: Angela Morrow Signature
Date "! -z7! 6 O/