HomeMy WebLinkAbout2226 W Elizabeth St - Applications/Air Conditioner - 06/16/2016From 9702299983 1.970.229.9983 Thu Jun 16 09:19:19 2016 MDT Page 4 of 8
FROM FAX NO. Jun. 16 2015 03:15PM P4/8
Cit Of Planning, Development & Transportation
y 2131 N. College Ave P.O. Box 580
Fort Collins Fort Collins, CO 80524
Phone 970-41,6-2740 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). VAir Conditioning
C7 Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighte ❑ Gas Log
❑ Heating Unit d Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater Cl Water Line ❑ Wood/Pellet Stove (must be CPA certified, provide make, model and
manufacturer). . .
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application # �311�d I Date LP — lD
For of ke use only
lob Site Address (required) Value of Construction (labor, materials, profit)
2226 W ELIZAHETH ST #A303 $2,590.00
Property Owner Name Address City/State zip Phone
RAMS PA.4tK APTS 2226 W 11Cl JZA11ETH ST #A 1I 0(1
Applicant Name Address City/State
Contractor
NORTHERN COLORADO AIR, INC.
Contractor City of Ft. Collins Sales Tax 4
Saks tax number is required by all contractors
26862
Address City/State
812 STOCKTON AVE FT COLLINS CO 80524
Zip Phone
Zip Phone
970-223-8873
Are you paying taxes here or by report? ,PJ Here ❑ Report
Are you paying with your trust account? Yes ❑ No
Is this a residential or commercial project? ErResidential ❑ Commercial
If residential, is It: Qegingle Family Detached A Condo/townhome (single family attached) 17 Duplex
❑ Multifamily (apartment) ❑.Garage
If commercial, Is It: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ office C] Retail
❑ Restaurant ❑ Other (explain
Is this building 5o years of age or more? ❑ Yes o If yes, you may need to contact Historic Presematlon
If this is for a demolition permit, what year was tlNr�� building constructed?
If pfior to 1975, 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: Lisl the company name or City of Ft Collins license #
Electrician Plumbpr 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:
Print Name: of / L Slgnatu _._...._ Date -4• �'� .