HomeMy WebLinkAbout2214 Summerpark Ln - Applications/Air Conditioner - 02/12/2020Planning, Development & Transportation
t.Of 281 N. College Ave P.O. Box 580
r„ffins Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
OVER-THE-COUWER PERMITS ONLY
This application is to be used to apply for the following parm'rts only (check all that apply Air Conditioning
❑ Demolition (Interior non-structural) El 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 # 15a n /-�) I D Date o2Z/
. For office use only
Job Siteddress 7,vired)�Y1 Value of C struction (labor, Y e ais, profit)
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Pr erty Owner Nap I Address City/State Zip ton
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tf �= 2
Applicant Nam Address City/State Zip Phone
Kathi McKinney Broomfield CO
Contractor Address City/State Zip Phone
Cooper Heating and Cooling 11780 Colman Way 80020 720-361-4245
Contractor City of FL Collins Sales Tax tr Are you paying taxes here or by report? ❑ Here ❑ Report
Sales tax numbe-&requlmdbyall mnractors Are you paying with your trust account? ❑ Yes ❑ No
Is this a residential or commercial 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 2,110 If yes, you may need to contact HistoricPres-,wbion
If this is for a demoiition permit, what year was the building constructed?
Ifpnor to 1975, you MY need an asbestos assessment to submit with this application.
Description of wo /
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*If lawn sprinider/ba ow preventer, must list licensed plumber. If first-time A/C, must list licensed electician.
subcontractors: List Use company name or City of R Collins license ri
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: Prino f J pate J— i
Print lYa e: I U.
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