HomeMy WebLinkAbout1208 Cascade Ct - Applications/Air Conditioner - 05/13/2016FROM :
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Fart Collins
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). f�Alr Conditioning
El Demolition (interior non-structural) ❑ Electrical Alteration (not service change) 4 Gas LighteF L3 Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing .❑ Sewer tine ❑ photo -voltaic
❑ Ventilation Q 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 #_ o `J Date I>
For office use only
gob Site Address (required)
1208 CASCADE CT
Property Owner Name
JENNIFER MCCAF
Applicant Name
Value of Construction (labor, materials, profit)
$3 270.00 _
Address City/State Zip Phone
Address City/State Zip -- Phone
Contractor Address City/State Zip Phone
NORTHERN COLORADO AIR, INC. 812 STOCKTON AVE FT COLLINS CO 80524 970-223-8873
Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? J1 Here 0 Report
Sale tax numbar&requ/rcdbya/lcontracforc. Are you paying with your trust account?
26862 Yes L'3 No
Is this a residential or commercial project? Residential ❑ Commercial
If residential, is it: Al Single Family Detached ❑ Condo/townhome (single family attached) 13 Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank CI Bar ❑ Church M Hotel/Motel 4 Medical office ❑ Office ❑ Retail
C7 Restaurant (3 Other (ex2builcling
in)
Is this building 50 years of age or more? d YesN0 0yes, you may need to contact Historic Presen�atlon
Ir this is for a demolition' permit, what year was constructed?
ff prior to 1p,75,, you w111 need an asbestos assessment to submit with this applicatipn.
Description of Work _
*If lawn sprinkler/backflow preventer, must list iicensed plumber. If first-time A/C, musL• list licensed electrician.
Subcontractors: List the company name or Cl[y of Ft Collins !!tense ,f'
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: i ` ' n
Print Name: VtyyjL Hal yiL signatu _ v�-l.(� �• C''
_ � ,Date _ 7 -L(42..