HomeMy WebLinkAbout1600 Dogwood Ct - Applications/Air Conditioner - 06/05/2017>/31/2 �1_201� 1f:T6AM F&VT TO: 19702246134 FROI%i�41AAV07234 T-5YZ P OQ4 le' F-e674
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�'�� 281 N. College Ave P.O. Box 560
A-6 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
O Demolition (Interior non-atrw:turaq ❑ Electrical Alteration (not service change) ❑ Gas Lighter O Gas Log
❑ Heating Unit 0 Lawn Sprinkler U Mobile Home replacement 0 Roofing O Sewer Une ❑ Photo-voltwc
O Ventilation O Water Heater O Water Una O Wood/Pellet Stove (must be EPA cerhfied, provide make, model and
manufacturer) -
Complete a0 applicable hrfonmatlon on the application. Incomplete applications will not be accepted
Applica>bW # 12,D) 1039 Date
For alkeeiae&*
,i
Value of Construction (labor, materials, profit)
9
Property Nang Address
Gty/State 2Jp
Phone
`'
Collins
Applicant Name Address
City/State Zip
Phone
Contractor Address
City/State rip
Phone
Fort Callins Heating and Air 08 mine
7484-455
Cadrdc bx City of R. Collins Sales Tax ti
Are you paying taxes here or by report?
❑ Here O Report
Saksawwmberls mq~byaowwxmm
Are you paying with your mist amount?
O Yes O No
Is this a residential or corpmercial project? MrResidential O Commercial
9 residesrtial, is it: ®'Single Family Detached 0 Condo/townhome (single fanuly attached) 0 Duplex
0 Multifamily (apartrnent) 0 Garage
if commercial, is it: O flank 0 ear O Church O Hotel/Motel O Medical office 0 Office O Retail
O Restaurant 0 Other (explain)
Is this building 50 years of Moor more? O Yes 17 No If yes, you may need to contact H/sbvc Pha wvab'an
If this is for a dentoltbom permit; what year was the building eonstruebed?
lfpnbr to 1973, J+nu WV need an asbestos assewnent to subwdt Wth this 4WIcadon.
Description of work
*If lawn sprmlder/baddlow preventer, must fist licensed plumber. If first-time A/C, must fist licensed electrician.
Subcont ad orm Lat the cmgmy name cr LRy of R CoMs kom 0
elemroan Pkmtw Medmi®I H1309 Roofer Other
I hereW admowledge that I have read this application and state that the above information is complete and correct. I agree to
cm* with all requlrements contained herein and city ordinances and state laws regulating building construction. I know that a
permit is not vatd until it has been paid and issued.
pprirrt flwne: Angela Morrow signature 1AL11-1
/c Y L�l Date _