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HomeMy WebLinkAbout608 Peyton Dr - Applications/Air Conditioner - 06/17/2016From 9702299983 1.970.229.9983 Fri Jun 17'10:58:18 2016 MDT Page 1 of 1 FROM FAX NO. Jun. 17 2015, 04:57PM P1/1 Planning, Development & Transportation F.0ty of 281 N. College Ave P.O. Box 580 ort Colons 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 t] Gas Log ❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement El Roofing ❑ Sewer Line ❑ Photo -voltaic Cl 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 # 6110omL03 Date 1. t �4 U - ri-ILP For ofce use only Job Site Address (required) Value of Construction (labor, materials, profit) 608 PEYTON Olt _ $30070.00 Property Owner Name Address City/State zip Phone JAN C7. ANOR 608 PEYI'ON DR, TC CO 80525 303-862-20 Applicant Name Address City/state Zip Phone Contractor Address City/State Zip Phone NORTHERN COLORADO AIR, INC. 812 STOCKTON AVE FT COLLINS CO SOS24 970-223-8873 Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? Pd Here ❑ Report Sales tax number Ismqulredbyallmntracrors. Are you paying with your trust account? p_(Yes ❑ No 26862 Is this a residential or co mercial project? jd Residential ❑ Commercial IF residential, is it: Single. Family Detached ❑ Cando/townhome (single family attached) © Duplex ❑ Multifamily (apartment) ❑ Garage If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office Cl Office ❑ Retail ❑ Restaurant ❑ Other (eYe5ullding ) _ Is this building 50 years of.age or more? ❑ Yeso If yes, you may need to contact Historic Preservation If this Is for a demolition permit, what year was t constructed? Ifprlor to 1975, you will need an asbestos assessment to submit with this application. Description of work—.---.----.. Ann AC *If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician. Subcontractors, List the con7pany name or C71y of Ft Collins 1lcense 41 Electrician{`^ 1 �3G . 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 ithas been paid and issued. Applicant: Print Mame:r`ay1�Signatu.Date (40f V�