HomeMy WebLinkAbout2118 Ayrshire Dr - Applications/Water Heater - 08/22/2018.FCity of Planning, Development, & Transportation Services
ort 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). ❑ Air Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit p Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation IffWater 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 #
For office use only
Date August 22, 2018
Job Site Address (required) Value of Construction (labor, materials, profit)
2118 Ayrshire Drive, Fort Collins, CO 80526 $2,017.00
Property Owner Name Address City/State Zip Phone
Charlene Spencer 2118 Ayrshire Drive Ft Collins, CO 80526 970.219.7818
Applicant Name Address Clty/State Zip Phone
Christina Evans 101 S Link Lane Ft Co, CO 80524 494-7632
Contractor Address City/State Zip Phone
Allen Service 101 S Link Lane Ft Co, CO 80524 484-4841
Contractor City of R. Collins Sales Tax ;t Are you paying taxes here or by report? ❑Mere ❑ Report
Sales tax number lsrequired byaAcontractors. Are you paying with your trust account? V Yes ❑ No
10010
Is this a residential or c'9mmerclal project? Residential ❑ Commercial
If residential, is it: V Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office Q Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes ❑ No If yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
Description of work, _ .P VW
*If lawn sprinkler/backnow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the companyname or G'ty of Ft Collins license #
Electrician Plumber Mechanical 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: X 122,119
Print Name: Christina Evans Signaturecol �� DateVVV
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