HomeMy WebLinkAbout2430 W Plum St - Applications/Air Conditioner - 04/12/2018Apr 10 2018 05:17PM HP Fax 9706130826
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Fort Collins Planning, Development $ Transportation Services
Community Development & Neighborhood Services
281 North College Avenue
Fort Collins, CO 80524 Main: 970.416.2740 Fax: 970.224.6134
OVER-THE-COUNTER PERMITS ONLY
This application is to be used to apply for the following permits only (check all that apply).VAir Conditioning
Electrical Demolition (interior non-structural) ❑ Eleccal Alteration (not service change) ❑ Gas Lighter Gas Log
❑ Heating Unit ❑ Lawn Sprinkler '❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater 0 Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
manuracturer).
Complete all applicable Information on the application. Incomplete applications will not be accepted.
Application # -310b 2 5 7D . Date 4r r � (t S
For of v use only 4-I'd
30b 51be Address (rawfr+ed) Value of Construction (labor, materials, pront)
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Property Owner Name Address citylstate Zip Phone
Applicant Name Address Clty/State Zip Phone
Contractor Address 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
S&estaarn~ ISAWJi WbYaucnr bae&M Are you paying with your trust account? t Yes ❑ No
Is this a residential or mmerdal p%ject? Residental ❑ Commercial
'If residentl�, Is It: Single Family Detadfed ❑ Condo/townhome (single family attached) ❑ Duplex
Multifamily (apartment) ❑ Garage
If commercial, Is tt: ❑ Bank O liar 13 Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retall
17 Restaurant ❑ Other (ex lain)
Is this building 50 Years of we or more? ❑ Yes No If yes; you may nerd to conmr hfLsf k PreAervatbn
If this Is for a demolition permit, what year was building constructed?
Descrlptlon of work
*If lawn sprinkier/bacidlow prevenber, must list licensed plumber. If first-time A/Cy must list licensed electrician.
Subcontractors: Ust the c»mpsny nerve or aty of Ft Cages /!c>°nme #
Elect iciart� i Mechanical Roofer Other
I hereby acknowledge that I have read this application and slabs 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.
PrI tnto Name: - [� Signatu _ _Date --
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