HomeMy WebLinkAbout4208 Stoneridge Dr - Applications/Furnace - 05/09/2016MAY-06-2016 08:54AM FROM -
9704848354 T-075 P.004/008 F-693
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 d 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 # t f (9 0 ;� `� f Date
For ofl9ce use only
Sob Site Address (required)
value of Construction (labor, materials, profit)
4208 Stoneridize Dr.
$5,000
Property Owner Name
Address City/State Zip
Phone
David Roth
4208 Stoneridge Dr. Fort Collins, CO 80525
(970) 286-4125
Applicant Name
Fort Coiling Heating and Air
Address Clty/State Zip
MR Commerce Dr- 44 Fort C-ol I ing, C 0 80524
phone
(270) 305.3 78
Contractor
Address City/State Zip
Phone
Fort Collins Heating and Air
208 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
Sales tax number ismquiredbyallcontractors Are you paying with your trust account?
❑ Yes ❑ No
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: CI Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes ❑ No Af yes, you may need to contact Histofic Preservation
If this is for a demolition permit, what year was the building constructed?
If prior to .t 975, you will need an asbestos assessment to submit with this application.
Description of work
*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 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 514�11AI!V