HomeMy WebLinkAbout1954 Angelo Dr - Applications/Air Conditioner - 09/12/2018Fort 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). 0 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 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 # uq) bi q � 4 Date 9i12/2018
For office use only
Sob Site Address (requlred)
Value of Construction (labor, materials, profit)
1954 Angelo Dr.
$ 4237.00
Property Owner Name Address
City/State • Zip
Phone
Doug Streed 1954 Angelo Dr.
Fort. Collins, CO 80525
493-3272
Applicant Name Address
City/state Zip
Phone
Doug Streed 1954 Angelo Dr.
Fort Collins, CO 80525
493-3272
Contractor Address
City/State Zip
Phone
DC Shortridge dba Gary Hil 1314 Webster Avenue
Fort Collins, CO 80524
493-3272
Contractor City of Ft Collins Sales Tax #
Are you paying taxes here or by report?
0 Here ❑ Report
Sales tax number is required by a//contractors
Are you paying with your trust account?
D Yes ❑ No
34734
Is this a residential or commercial project? 0 Residential 0 Commercial
If residential, is it: 0 Single Family Detached ® Condo/townhome (single family attached) 0 Ouplex
C Multifamily (apartment) 0 Garage
If commercial, is it: 0 Bank 0 Bar 0 Church 0 Hotel/Motel G Medical office 0 Office 0 Retail
E3 Restaurant 0 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?
Ypnor to 1975, you will need an asbestos assessment to submit with this application.
Description of work Replacing AC with a 3.5-ton. 13seer
*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 #
eectrician Plumber Mechanical H-1654 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: Dennis Shortrid a �P:==-----
Print Name: 9 Signature Dennis Shortridge Date
9/12/2018