HomeMy WebLinkAbout3348 Santa Fe Ct - Applications/Air Conditioner - 05/22/2017>/19/YM�T9-201T01G:OTAN` MFfi01JFT
TO : 19702246134 FROI1 g4jaAJO7234 T-404 P 005/0IIl : F-3095
Fort 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
❑ Demolition (interior non-structural) 0 Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement O Roofing ❑ Sewer Line ❑ Photo-voftaic
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable i Information On the application. Incomplete applications will not be accepted
Application # I 1 � %®� Date
For oA7te usie only
Sob Ste Address (required)
Value of Construction (labor, materials, profit)
Property Owner Name Address
City/State Zip Phone
&LcallianA 3549k SQJ106 f4L
U F 1111,14
Applicant Name Address
City/State Zip Phone
Fort Coiling Heating anti Air 208 Commerce Dr-
#4 Eort Collins, CO 80514 (970) 305-3478
Contractor Address
City/State Zip Phone
Fort Collins Heatine 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 ❑ Report
Salereurnumberfir rerlwredbyaeQ%Wi3dxs.
Are you paying with your trust account? ❑ Yes ❑ No
Is this a residential or caoopwrrr'ieercial project? 111 Residential ❑ Commercial
If residential, is it: [tW&ngle Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: O 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 budding constructed?
If prior to 19225, you will need an asbestos assiessment to submit with this application.
Description of work
*If lawn sprinkler/baddiow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subeontractom. List Me company name or Gly of Ft CoOins license *
Electrioan Plumber Mechenjdl 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
M