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HomeMy WebLinkAbout4207 Shiloh Ct - Applications/Air Conditioner - 09/28/2019Fciityof P/arming, DevelopmentTransportairon Services �ort l�I1S Community Development & Neighborhood Services d..- 281 North College Avenue Fort Collins, CO B0524 Main: 970.41(12740 Fax 970.224.6134 OVER-THE-COUNTER PERMITS OLLV This application is to be used to apply for the following permits only (check all that apply).• Air Conditioning ❑ Demolition (interior non ❑ ❑ectrical Alteration (not service change) ❑Gas Light Gas Log ❑ Heating UnLawn Sprinkler ❑ Mobile Home replacement ❑ Rooting ❑ Sewer Line ❑ Photo -voltaic ❑ VentlYatron . er Heater ❑ Water Line ❑ WoodlPellet Stove (must be EPA certified, provide make, model and manufacturer Complete all applicable information on the application. Incomplete applications will not be accepted. Application # �) M I �� Date September 26, 2019 For a1%usewdy lob Site Address (1epuired) Value of Construction (labor, mateials, profit) 4207 Shilo Ct, Fort Collins, Colorado 80525 $6367.00 Property Owner Name Address city/state Zlp Phone Ken Bledsoe 4207 Shilo Ct Ft Collins,CO 80525 970-229-9648 Applicant Name Address City/State Zip Phone Christina Evans 101 S Link Lane Ft Co, CO 80524 494-7632 Contractor Address aty/State 2•ipp Phone Allen Service 1015 Link Lane Ft Co, CO 80524 484-4841 Conitadnr City of Ft. Collins Sales Tax # Are you paying taxes here or by report? ❑ ere ❑ Report Susie rnwnber1gngreredbya#cw*ac&m Are you paying with your to st account? VYes ❑ No 10010 is this a residential or Wmmerclal project? q=dential ❑ Commercial If residential, is it 'M Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex ❑ Muttifamily (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 ©No Yyew, you maynead fo mnlactHbWfic Preswmhhrr If this is for a demolition permik what year was the building constructed? Description of work Ramme e3"s" g AC aid replace dlri, nee like AC *If lawn sprinkler/baddlow preventer, must list licensed plumber. If first-time A/C, must: list licensed electrician. Subcontractors: List MecumpanynamearQycffta 6n &mase# eectridan Plumber Medhanlca Rom Other I hereby acknowledge that I have read this application and state that the above information is complete and correct I agree W comply with all requirements contained hereln and city ordinances and state laws regulating bung construction. I know that a permit is not valid until it has been paid and issued. Applicant: ChrtWa Evans PfinName: Signaturegff� BoAs pate Revridandma==7