HomeMy WebLinkAbout1918 Ridgewood Rd - Applications/Air Conditioner - 07/25/2017PLEASE MAIL PERMIT TO HO u E OWh ER
�rt Collins
Planning, Development, & Transportation Services
Community Development & Neighborhood Services
281 North College Avenue
Fort Collins, CO 80524 Main: 970.416.2740 Fax: 970.224.6134
OVER-THE-COUNTER PERMITS ONLY
This application Is to be used to apply for the following permits only (check all that apply), 4Air 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 # U 110.T I Date
For of to use only
Sob Site Address (nequired) Value jf Construction (labor, materials, profit)
p �v
Property Owner Name Address ne
City/State Zip pho
1S0 MUto 1Ajq_-\9
Applicant Name Address City/State ZIP phone
Fort Collins Heating & Air 208 Commerce Dr. #4 Fort Collins, CO 80524 970.484.4552
Contractor Address City/State Zip Phone
Fort Collins Heating & 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
Sales tax n�unedbyall rono-acmrs Are you paying with your trust account? Yes No
Is this a residential or mmercial pro)ect7 Residential ❑ Commercial
If residential, is it: ISingle 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 SO years of age or more? OYesloNo If yes, you may need to contact historic preservation
If this is for a demolition permit, what year was the building constructed?
Description of work
*If lawn sprinkler/baddlow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: Ust the company name or City Off Collins Ikense 0
Electrician Plumber Mechanical H1309
War 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 constnrcdon. I know that a
permit Is not valid until
�knhas been paid and Issued.
Print Name: �I l ll �x x 1 l t i `' r\ t 4CM
Signature pate roll
ReAlfw date 2 M17