HomeMy WebLinkAbout600 Skysail Ln - Applications/Air Conditioner - 08/03/2017From
08/03/2017 06 47 #699 P 001/002
aot�11
FCiof
ort Collins
Planning, Development & Transportation
281 N. College Ave P.O. Box 58o
Fort Collins, CO 80521
Phone 970-416-2740 Fax 224-6134
This application is t4l", 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 D Gas Log
❑ Heating Unit O Lawn Sprinkler D Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
• Ventilation ❑ Water Heater ❑ Water Line 0 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 #_ 6 I r M LN 3 7 Date
ror otflce use only
Sob Site Address (required)
Value of Construction (labor, materials, profit)
Property Owner Name Address
City/State Zip phone
\� q
Applicant NYme Address
City/State Zipp 4) Phone
Contractor Address
City/State Zip Phone
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report? ItHere *Report
Saes tar number & mqured tyay av*aciws
Are you paying wir your trust account? KYes tj No
Is this a residential or commercial project?esldential ❑ Commercial
If residential, is it �ingle Family Detached Cl Condo/townhome (single family attached) ❑ Duplex
Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motei ❑ Medical office O Office ❑Retail
O Restaurant O Other (explain)
Is this building 50 years of age or morel ❑ Yes O No Ifyrs, ynu may need to contactH&Orcc presenabon
If this is for a demolition permit, what year was the building constructed7
tfprior to 1975, ynu wN/need an asbeRbsassesment to submrt with thcs app/icatron
Description of
it lawn spnnvier/backnow preventer, must list licensed plumber If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or Gty of R COMM license 0
Electrician Plumber Mechanical Roofer ether
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: R,CD-Q _ + A Qk•••• Signature • • &a LAJtlDate _���_