HomeMy WebLinkAbout616 W Mulberry St - Applications/Air Conditioner - 04/03/2017From 9702299983 1.970.229.9983 Mon Apr 3 09:41:19 2017 MDT Page 1 of 1
FROM FAX NO. Apr. 03 2017 03:40PM P1/1
City of Planning, Development & Transportation
281 N. College Ave P.O. Box 580
! ,.,`Qrl} Cothns 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). O Air 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 d 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 # L I M(W
For offlee use only
Sob Site Address (required)
616 W MULBERRY ST
Date 04/03/2017
Value of Construction (labor, materials, profit)
K040.00
Property Owner Name Address City/State Zip Phone
SHELDON HOUSE BED & BREADFAST 9313 LAWN BROOK DR, VERONA WI 53593 608-576-7765
Applicant Name 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? O Here ❑ Report
5alestax numberisrequlmdbyall conbam^ Are you paying with your trust account? R Yes ❑ No
26862.
Is this a residential or commercial project? ❑ Residential O Commercial
If residential, is it: 13 Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: O Bank O Bar ❑ Church 13 Hotel/Motel 0 Medical office ❑ Office ❑ Retail
O Restaurant p Other (explain) SEOAND BREAKFAST
Is this building 50 years of age or more? ® Yes ❑ No if yes, you may need to ecniact H/sroric Preservation
If this is for a demolition permit, what year was the building constructed?
If pnor to 197S, you will need an asbestos asnessment to submit with this applicatlun.
Description of work ADD MINI SPLIT AC THERE IS ALREADY ANOTHER UNIT THERE & WE
PUTTING 17 NGXT TO THAT)
T u
*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 FL Collins license f
Electrician WIRED ELECTRIC Ilumber 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: KARENA w.+o-.w..�-----•
Print Name: KARENA HUNTWORK_ signature HUNTWORK_Date 04/03/2017