HomeMy WebLinkAbout433 Riva Ridge Dr - Applications/Air Conditioner - 05/26/201701
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Fort Collins
TO. 19702246134 FROI+ q4j&107234 T-494 P lIlI6/UUr F-4966
Planning, Development & Transportation
281 N College Ave P.O Box 580
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
OVERaTHE-COUNTER PERMITS ONLY
This application is to he used to apply for the following permits only (check all that apply). ❑ Air Conditioning
O Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Healing Unit L3 Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stave (must be EPA certified, provide make, model and
manufacturer)
Complete all applicable information on the application. Incomplete applications will not be accepted
Application # IbIllDM�5 4 Date
Aar ofte use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
e o 2
Property Owner Name Address
City/State Zip
Phone
r4 Maltn'A060 -112-1 Nousmftr
rk Or &A Calrin-5 CO
B06250.206
Applican Name Address
Fort Collins Heating and Air 209
City/State Zip
Phone
Contractor Address
City/State Zip
Phone
Fort Collms Heating and Air 208 Commerce Dr. ##4 Fort Collins CO 80524
970 484-4552
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
❑ Here 0 Report
Saks &wn is required by a#wntracrom
Are you paying with your trust account?
❑ Yes ❑ No
Is this a residential or co
erual prolect7 111"Residenbal ❑ Commercial
If residential, is it: Ste' mgle Family Detached O Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it ❑ Bank ❑ Bar ❑ Church 0 Hotel/Motel ❑ Medical office ❑ Office 13 Retail
0 Restaurant ❑ Other (explain)
Is this building SO years of age or morel d Yes ONO If ye4 you may need to contact Hrstor/c Preservation
If this is for a demolition permit, what year was the building constructed?
Yprior to 1975, you will need an asbestos assessment to submit with this applicabon
Description of work rdnlnc+� A►G
*If lawn spiinkler/baddlow preventer, must list licensed plumber If first-time A/C, must list licensed electrician
Subcontractors: List the company name or G ly aFn Collins license if
Eleclnoan _ Plumber Mechanical 141309 Roofer
Other
I hereby acknowledge that I have read this applicabon 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
it Date
1668