HomeMy WebLinkAbout1012 Stonecrop St - Applications/Air Conditioner - 02/27/2020Feb 26 2020 10:56AM Swan 9706130826 page 1
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-TH&COUNTER PERMITS ONLY
IT is application Is to be used to apply for the following permits only (check all that apply).
Alr Conditioning ❑ Electrical Alteration ❑ Gas Lighter ❑ Gas Log Heating 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.
F2-0o 1677 —AICL
Application # U 2,00 16 7Q `
Pow olifce use only
Incomplete applications will not be accepted.
Date Z/Z_7/20Z-b
Sob Site Address (required)
Value of construction (labor, materials, profit)
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Property Owner Name Address
City/State Zip Phone
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Applicant Name Address
City/State Zip Phone
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Contractor Address
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City/State Zip Phone
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Contractor City of Ft Collins Sales Tax #
Are you paying taxes here or by report? Here ❑ Report
sa/es tax numberIsmquiredbyacontradors
nt? Are you paying with your trust accouYes ❑ No
Is this a residential or commerdal project? Residential ❑ Commercial
If residential, Is It: ❑ Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ 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 ❑ No Ifyes, you may need to contact Historic Preservation
If this Is for a demolition permit, what year was the building constructed?
*If lawn sprinkler/backlow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or O'ty of Ft Collins license #
Electridan Plumber Mechanical 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: WK
Print Name.
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