HomeMy WebLinkAbout221 Lyons St - Applications/Air Conditioner - 02/15/2017114 f JE6174_ZOl7111 : & PS;04F TO : 19702246134 FROM: 7Y8 484E85d 34 T-588 "'M008 9-218
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fort olhns*pe if ' Fort Collins, CO 80524
homwumer Phone 970-416-2740 Fax 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 non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
Cl 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 # 6 I70(-) 7,51 Date Z h5 11 j7
For offlm use ony
lob Site Address llm wlmd)
Value of Construction (labor, materials, profit)
221 Lyons St
$5,061
Property Owner Name Address
City/State Zip
Phone
Molly Mclaughlin/Zach Taylor 221 Lyons St
Fort Collins 80521
(706) 333-1649
Applicant Name Address
City/State Zip
Phone
Fort Coiling Heating: and Ail 2011 Commerce Dr.
Contractor ' Address
#4 Fort Collins, C0 90524
City/State Zip
(97Q) 305-3478
Phone
Fort Collins Heating and Air 208 Commerce Dr. #4 Fort Collins. CO 80524
970 484-4552
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
❑ Here ❑ Report
Saks tm nwnber is raw#W by all mnvacom
Are you paying with your trust account?
❑ Yes ❑ No
Is this a residential or commercial project? P Residential ❑ Commercial
If residential, is it: 10 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? O Yes O No If yes, you may need to contact Historic Fi°esermlion
If this is for a demolition permit, what year was the building constructed?
Ifpror to 1975, you will need an asbestos assessment to submit with this appl/cat/an.
Description of work
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subeonbactors: Ust Me company name or City of ft Collins license 0
Beciridan Plumber Mechanical H1309 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.
Appikaft
Print Name:_ Angela Morrow signature ��� pate V/ /1