HomeMy WebLinkAbout2960 Southmoor Dr - Applications/Furnace - 10/31/2019City of Planning, Developmen4 & Transportation Services
�F+�&t Collins Community Development & Neighborhood Services
281 North College Avenue
Fort Collins, CO 80524 Main: 970,4162740 Fax 970224.6134
OVER-THE-COUNTER PERMITS ONLY
This application is to be used to apply for the following permits only (check all that apply). ¢ZPiir Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighted p 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 # 6ft %mow. Date October 30, 2019
For a>TRemea* Ia,IoIILlCl(oq
Sob Site Address (requLed) Value of Construction (labor, materials, profit)
2960 Southmoor Dr, Ft Collins, Colorado 80525 $7546.00
Property Owner Name Address city/State ZIP Phone
Sandra McDonald 2960 Southmoor Dr Ft Collins, CO 80525 970-266-9573
Applicant Name Address city/state Zip Phone
Christina Evans 1015 Link Lane Ft Co, CO 80524 494-7632
Contractor Address aty/State Tapp Phone
Allen Service 1015 Link Lane Ft Co, CO 80524 484-4841
Gmtrachhr City of FL Collins Sales Tax # Are you paying taxes here or by report? ❑ ere ❑ Report
Sal ftrmmd er1sn r6redbyaDm,6actam Are you paying with your trust account? Yes ❑ No
10010
Is this a residential or qmmerdal project? Residential M Commercial
If residential, is it `M Single Family Detached ❑ Condo/l ownhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: la Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 5o years of age or morel ❑ Yes ❑ No Ifyes, you mayneed to mntadHtsWc PAzwyation
If this is for a demolition permit, what year was the building constructed?
Description of work Ru w mdsmy AC md.epinm with � ae AC
*If lawn sprinkler/bacldtow preventer, must list licensed plumber. If first-time A/C.. must fist licensed electrician.
Subcontractors: List the conawyname ar01yofltCaft ski #
9ectridan Plumber Medmnial Roofer other
I hereby acknowledge that I have read this application and state that the above information is complete and correct. I agree m
comply with all requirements contained herein and city ordinances and state laws regulating building conrsbudion. I know that a
permit is not valid until it has been paid and issued.
Applicant ChrUtbarwEvavra
Print Name: Signature /r V �6 r l Lf LNt Ci(�� t)abe
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