HomeMy WebLinkAbout1600 Scarborough Dr - Applications/Air Conditioner - 02/23/2018i
Planning, Development & Transportation
City}Of 281 N. College Ave P.O. Box 580
FOIrl Collins 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). EI 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
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
I
Complete all applicable information
on the application. Incomplete applications will not be accepted
Application #R UD,`lY� l Date 2/23/2018
11
For office use only
Job Site Address (required)
Value of Construction'(labor, materials, profit)
1600 SCARBOROUGH DR
$3,740.00
Property` Owner Name
Address City/State Zip
Phone
BOB MEYER
1600 SCARBOROUGH DR, FT COLLINS CO 80526
970-286-1266
Applicantt Name
Address City/State Zip
Phone
Contractor
Address City/State Zip
Phone
NORTHERN COLORADO AIR INC.
812 STOCKTON AVE, FT COLLINS CO 80524
970-223-8873
Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report?
EI Here ❑ Report
Sales tax number is required by all contractors
Are you paying with your trust account?
X Yes ❑ No
26862 +�
A
Is this a `residential or commercial project? El Residential ❑ Commercial
If residential, is it: 0 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
�i ❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes N No If yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
If prior to 1975, you wdl need an asbestos assessment to submit with this application.
Description of work ADD AC
6
*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 WIRED ELECTRIC 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: KARENA ON" awKRR
RE"�"®ENR HU RN KORK OTo�RK
Print Name: KARENA HUNTWORK signature HUNTWORK .R. �"`R""° `-°s Date 02/23/2018