HomeMy WebLinkAbout2155 Orchard Pl - Applications/Air Conditioner - 10/10/2019 (2)Fort 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
TF is application is to be used to apply for the following permits only jeheck all that apply).
Air Conditioning ❑ Electrical Alteration ❑ Gas Lighter ❑ Gas Log MHeating Unit ❑ Lawn Sprinkler
❑ Mobile Home replacement ❑ Sewer Line ❑ 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 #1
For office use only 2r )k Ok H
Date 10/09/2019
Job Site Address (required)
Value of Construction (labor, materials, profit)
2155 Orchard PI. #N83 Ft Collins, CO 80521
$8588.50
Z4 A I y , a�
Property Owner Name Address
City/State Zip
Phone
Trinity Properties/Renu Apts 2155 Orchard Place #N83 Fort Collins, CO 80521
480-364-8230
Applicant Name Address
City/State Zip
Phone
Madeline Goetz 4600 Innovation Dr.
Suite 102 Fort Collins CO 80525
970-399-9940
Contractor Address
City/State Zip
Phone
JMP Heating 4600 Innovation Dr. Suite 102
Fort Collins, CO 80525
970-399-9940 E]
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
❑ Here V!�teport
Sales tax number is required by all contractors
Are you paying with your trust account?
'Yes ❑ No
52310
Is this a residential or commercial project? IN Residential ❑ Commercial
If residential, is it: ❑ Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
8 Multifamily (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 I3 No If yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
De sc iption of work install 1.5 ton ac 13 SEER, Install furnace 44k BTU single stage twin 80%
P w kC efficient, Inistall 60 amp disconnect non-tusiule disconnect
*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 #
Electrician M E^ 111 S 1 Plumber Mechanical H- 3 f S I Ef 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: Madeline Goetz
Print Name: Signature
Date 10/9/20