HomeMy WebLinkAbout1760 Overlook Dr - Applications/Air Conditioner - 07/14/2016JUL-19-2016 10:03AM FRONh
9704948354 T-814 P.001 F-216
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). ❑ Air Conditioning
13 Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler d 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 # 811e6LIbon Date
For office use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
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IkLAI;12�0K
Property Owner Name Address
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City/State Zip
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Phone
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Applicant Name Address
City/State Zip
Phone
Fort Collins Heating and Air 208 Commerce Dr.
#4 Fort Collin.-;, rO 5
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 R. Collins Sales Tax #
Are you paying taxes here or by report? ❑ Here ❑ Report
Sales tax number isrequ#W by allconhadors
Are you paying with your trust account? ❑ Yes ❑ No
Is this a residential or commercial project? *Residential ❑ Commercial
If residential, is it: 12 Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank . ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes ❑ No Ifyes, you may need to contact Histoncpreservabon
If this is for a demolition permit, what year was the building constructed? _
Ifpnor 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: List the companyname or City of Ft Collins license #
Elettriciarn 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 716116