HomeMy WebLinkAbout1437 Sanford Dr - Applications/Air Conditioner - 11/15/2017City of Planning, Development, & Transportation Services
Fort Collins 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). [A Air 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 # ?A -I D` _1L43 Date
For ofce use only V) `-'I 6� q 4
11 /15/2017 1546 .
Job Site Address (regmred) Value of Construction (labor, materials, profit)
1437 Sanford Drive $5750 00
Property Owner Name Address City/State Zip Phone
Luke Scanlon 1437 Sanford Drive Fort Collins, Co 80526 485-9732
Applicant Name Address City/State Zip Phone
Luke Scanlon 1437 Sanford Drive Fort Collins, Co 80526 485-9732
Contractor Address City/State Zip Phone
Air Products Htg & Cooling 800 Stockton Ave #3 Fort Collins, Co 80524 224-3295
Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? DO Here ❑ Report
Sales tax number is requved by all contractors Are you paying with your trust account? ❑ Yes W No
Is this a residential or commercial project? ® Residential ❑ Commercial
If residential, is it: C4 Single 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 50 years of age or more? ❑ Yes [A No If yes, you may need to contact Histonc Preservation
If this is for a demolition permit, what year was the building constructed?
Description of work Replace existing Furnace and AC unit
*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 #
Electrician Plumber Mechanical H-1183 Roofer 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 construction. I know that a
permit is not valid until it has been paid and issued.
Applicant:
Print Name: Mike Giarrusso Signature 7y i Date 11/15/2017
Revision date 2/6/2017