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HomeMy WebLinkAbout128 S College Ave - Applications/Mechanical - 08/29/2017City ofFort Collins �D Planning, Developrnent tic Transportation 281 N, College Ave P.O. Box 580 Fort Collins, CO 80524 Phone 970-416-2740 Fax 224-6134 OVER-18HE-COUNTER PE;RMITSONLY This application is to be used to ;apply for the following permits only (check all that apply). ❑ Air Conditioning ❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter 0 Gas Log ❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic . ❑ Ventilation ❑ Water Heater ❑ Water Line Cl Wood/Pellet Stove (must be EPA certified, provide make, model and manufacturer). Complete all applicable information on the application. Incomplete application:; will not be accepted. Application # Ial-t— Bate For ofce use only ---�-- Job Site Address (required) Value of Construction (laoor,materials, profit)— 12�5:C©�l�r � —FTC ti C_494b31.00 Property Owner Name Address City/State Zip Phone j Applicant Name Address City/State Zip � F ((Contractor - Address - City/State Zip Phone 3i(, LOj'1"11'✓1��° �'' ✓E'. ,.. i_ E �rJ ^7>y'.yy; Contractor City of Ft. Collins Sales Tax' # y Are you paying taxes here or by report? ❑ HePe 1)e ort sales tax number is re uired b all contractors. ' p 4 y Are you paying with your trust account?ygJlYes ❑ No Is this a residential or commercial prcject? ElR.esidentialXC�o�mmercial — If residential, is it: ❑ Single Family Detached - El Condo/townhome (single family attached) ❑ Duplex ❑ Multifamily (apartment) Cl Garage If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office Retail El Restaurant ❑ Other (explain) _ _ Is this building 50 years of age or more? ElYes ❑ No If yes, you may need to con tact HistoricPreseruation If this is for a demolition permit, what year was the building constructed? lfprior to 1975, you will need an, asbestos assessment to submit with this application, -- ----- Description of work I NCB [_-F *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 Ft Collins license # Electricia Plumber Mechanical_ Roofer __. Other I Hereuy acKnowleoge tnat 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, if know that a permit is not valid until it has been paid and issued. I,--, Applicant: —� ��1� Print Name: Signature Date t& j WE .wou_uc> Lu_e-z C, puA4e-tj tTT. City of Community Development & Neighborhood Services 281 North College Avenue Fort} Collins Fort Collins, CO 80524 970.416.2740 . Over the counter permit info sheet for., New and replacement hvac roof -too equipment The following information must be included on commercial/multi-family projects to approve the permit. 1. The hvac equipment is: Replacement of existing equipment. ❑ New/additional roof -top equipment. 2. For Replacement equipment: Equipment is the same weight or lighter and similar or smaller size/footprint. ❑ Equipment is heavier and will provide engineered documentation showing roof can support new equipment or modifications that must be done to support such equipment. Replacement equipment is in the same location and not taller than previous. ❑ Replacement equipment is in new location and/or taller. 3. For New equipment: ❑ See attached engineered documentation showing roof can support new equipment or modifications that must be done to support such equipment. 4. Is outside air (ventilation) being provided for building occupants through this hvac system (see 2009 IMC chap 4). How will equipment be set to meet this requirement? If not how is ventilation provided? w ;+'i E c.on o t-. r Z--e-," Applicant i nature and date F1 7 (Form updated 9-22-2010)