HomeMy WebLinkAbout2044 Falcon Ridge Dr - Applications/Air Conditioner - 06/10/201616R261
Planning, Development & Transportation
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Phone 970-416-2740 Fax 224-6134
-�R-THE-COUNTER PER ONLY
This application is to be used to apply for the following permits only (check all that apply). QAir Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ 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 # 1JI1fo4,ic1 Date 0611011R
For office use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
2044 Falcon Ridge Dr, FC 80528
$4731.00
Property Owner Name Address
City/State Zip
Phone
Cobey Wess 2044 Falcon Ridge Dr Fort Collins, CO 80528
970-691-1140
Applicant Name Address
City/State Zip
Phone
Contractor Address
City/State Zip
Phone
IMS Heating and Air 5213 Longs Peak Rd, Unit A Berthoud, CO 80513
970-532-0123
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
❑ Here ❑ Report
Sales tax number is required by all contractors
Are you paying with your trust account?
❑ Yes ❑ No
Is this a residential or commercial project? la Residential ❑ Commercial
If residential, is it: IN 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 If yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
If prior to 1975, you will need an asbestos assessment to submit with this application.
Description of work emplace AG
*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 r#
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
Print Name: JAVnL�_ A C 1,\
Date Le — l 0 1 ('