HomeMy WebLinkAbout1421 Sheep Creek Ct - Applications/Air Conditioner - 01/30/20182D9Cb
'FCitya( Planning, Development, & Transportation Services
� Cottons Community Development & Neighborhood Services
N��� 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), Y 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 # 2,1C000 lit�q ; Date ( � 3o `y?)
For ofte use ony
Job Site Address (requ/red) Value gf Constru on (labor, materials, profit)
11
Property Owner Name . Address City/State Zip Phone CHiJ
b A
Applicant Name Address city/State Zip Phone
Fort Collins Heating & Air 208 Commerce Dr. #4 Fort Collins, CO 80524 970.484.4552
Contractor Address Gty/State Zip Phone
Fort Collins Heating & Air 208 Commerce Dr. 94 Fort Collins, CO 80524 970.484.4552
Contractor Gty of Ft. Collins Sales Tax # Are you paying taxes here or by report? ❑ Here ■ Report
Sales tun umber IsrEVdmdbyall mao-acrom IbInc(Q Are you paying with your trust account? ■ Yes ❑ No
Is this a residential or commercial project? `0 Residential ❑ Commercial
If residential, is it: ■ 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 E NO !f yes, ynu 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/backfiow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or O y ofRCollins license #
Electrician Plumber Mechanical H1309 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: C C
Print Name. Signature11'V Date�—
Revision date 202017