HomeMy WebLinkAbout6309 Buchanan Ct - Applications/Air Conditioner - 04/05/20171/412W-04-20F0:6AIM FR;
City, C1000
ollins
TO:19702246134 FROM: 87fhfflg$7234 T-070 P-DA F-4
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
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 O Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation O Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable information on the application. Incomplete applicat75[l
will not be accepted.
I.
Application # D 19 153 Date -7
For oA£ae um only
Sob Site Address (mgwmd)
Value of Construction (labor, materials, profit)
6309 Buchanan Ct.
$6,270
Property Owner Name Address
City/State Zip
Phone
Deb Courtner 6309 Buchanan Ct. Fort Collins 80525
833-0056
Applicant Name Address
City/State Zip
Phone
Fort Collins Heating and Air 209 Commerce
Dr- #4 Fort Collins- CO 90524
(97Q) 3
Contractor Address
City/State Zip
Phone
Fort Collins Heating and Air 208 Commerce Dr. #4 Fort Collins CO 80524
970 494-4552
Conbactoor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
❑ Here ❑ Report
Sa/esAmrnwnberIsregidwdbyall wn&actom
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 30 years of age or more? ❑ Yes O No If yes, you may need to contact Historic Preservat/on
If this is for a demolition permit, what year was the building constructed?
If prior to 1975, ynu wi//need an asbestos assessment to submit with this application,
Description of work replace AC
*If lawn sprinkler/bacldlow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontiactorm List the company name or sty of Ft Colons Ilcense #
Mectrician 6AW 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. It
Applicant: I N1101 ram - /f I / l�
Print Name: Angela Morrow Signature Date