HomeMy WebLinkAbout1201 Canvasback Ct - Applications/Air Conditioner - 12/10/2019City of Planning, Development & Transportation Services
Fort Collins Community Development & Neighborhood Services
281 North College Avenue
Fort Collins, CO 80524 Main: 970.416.274D 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 nonstructural) ❑ 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 #.
roroflrce rile arty
Date December 9, 2019
Job Site Address (requh d) Value of Construction (labor, materials, profit)
1201 Canvasback Ct, Ft Collins, Colorado 80525 $7137.00
Property Owner Name Address City/State Zip Phone
Zach Schroeder 1201 Canvasback Ct Ft Collins, CO 80525 970-388-6032
Applicant Name Address aty/State ZIDp Phone
Christina Evans 1015 Link Lane Ft Co, CO 80524 494-7632
Contractor Address aty/State Trp Phone
Allen Service 1015 Link Lane Ft Co, CO 80524 484-4841
Cantractior City of Ft. Collins Sales Tax # Are you paying taxes here or by report? ❑ jiae ❑ Report
se tar mmzbw&wq&edbyagcoanacmm Are you paying with your trust acoauntl VYes ❑ No
10010
Is this a residential or metcial project? Residential ❑ Commercial
If residential, is it: Single Family Detached ❑ Condo/tmnmhome (single family atradred) ❑ Duplex
❑ Multifaouly (apartment) ❑ Garage
If commerical, is ft ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medial office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes ❑ No Yyeas, you maned to contacthfisfwkfirvsew# n
If this is for a demolition permit, what year was the building constructed?
Description of Work P " CO5A19 AC aril rep]=with like new AC
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed elech idan.
subcontractors: LuttheaurpwynameorOWaff Cohfthbmwi'
Hectiivmr PlunberMedianld Poorer Other
I hereby admowledge that I have read this application and state that the above information is complete and correct I agree is
comply with all requirements contained herein and city ordinances and state laws regulating building construction. I know that a
Permit is not valid until it has been paid and issued. f
Applicant: Christ'uta Evan$ �j�r 6111 1i U!M k,
Print Name: SlgnaWre. Date
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