HomeMy WebLinkAbout1919 Dorset Dr - Applications/Air Conditioner - 09/11/20176i t 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). M Air Conditioning
O Demolition (interior non-structural) O Electrical Alteration (not service change) O Gas Lighter O Gas Log
O Heating Unit O Lawn Sprinkler O Mobile Home replacement O Roofing G Sewer Line O Photo -voltaic
O Ventilation O Water Heater ❑ Water Line O 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 #_ V `� v Date 9/11/2017
foroAke sm on(y
Job Site Address (mgaiad) Value of Construction (labor, materials, Profit)
1919 Dorset Drive $3,523.D0
Property Owner Name Address City/State ZIP Phone
Margaret Aunon 1919 Dorset Drive Fort Collins, CO 80526 690-3668
Applicant Name Address Clty/State ZIP Phone
Margaret Aunon 1919 Dorset Drive Fort Collins, CO 80526 690-3668
Contractor Address City/State ZIP Phone
DC Shortridge dba Gary Fill 1314 Webster Avenue Fort Collins, CO 80524 493-3272
Contractor City of Ft Collins Sales Tax # Are you paying taxes here or try report? m Here O Report
SNest""`"tOr&fe `Brada'all &Vbam Are you Paying with r trust account? M Yes O No
34734 Y�
Is this a residential or commercial project? III Resldentlal 0 Commercial
If residential, is it. M Single Family Detached 12 Condo/townhome (single family attached) m Duplex
C Multifamily (apartment) G Garage
If commercial, Is it: O Bank 12 Bar G Church 0 Hotel/Motel O Medical office 0 Office G Retail
0 Restaurant t7 Other (explain)
Is this building so yeah of age or more? 0 Yes O No /ryes, you may nerd (D confI& y{yyoyc. pig rmhpn
If this Is for a demolition permit, what year was the building constructed?
!f prior to 1975, you w///need an asbestos assemment to submlf w/Ur this gAWc as
Description of Work Install 2.5 ton mndansina unit (I3SEER)
*If lawn sixftler/baddlow pieventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcomradors: Ust the company name ar ply off/ Cod&ts&Efm t
iaeciridar-CM slde Electric p,,a„ber MerlardeWH•1654 Roofer Dow
7 hereby acknowledge that I have need this aPPBCation and state that the above b1formatlon 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 valld until It has been paid and issued.
Print :Shelly Swanson -kl4+"S4— Dabs