HomeMy WebLinkAbout2313 Coventry Ct - Applications/Air Conditioner - 07/31/2018FCity of Planning, Development, & Transportation Services
ort Collins 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). ,b(Air Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
O 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 # b ?)_0Ua 5S
For office use only
Date 1- '' ! - l9
lob Site Address (required) Value of Construction (labor, materials, profit)
3/ 3 COl2 y CT . q> 577. od
Property Owner Name Address City/State • Zip Phone
E LE N 43 6UcoEN /3Lv f<CD S'0Sa.t 303-4 ' 1— 39
Applicant Name Address City/State Zip Phone
s Trs 5�03 D,.f/V,�;IgV6 4.V /C0 ?0637 To
Contractor Address City/State Zip Phone
ct_,fFc i' e. IgVI:. (-\) co Fv53"1 'z;;/70- -e�9 3>
Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? ❑ Here ❑ Report
Sales tax number is yyrequired by all ontraciors. Are you paying with your trust account? ❑ Yes ❑ No
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Is this a residential or commercial project? XResidential ❑ Commercial
If residential, is it: 1@ Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
0 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 $. No If yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
Description of work f}/ C _N.57'i'Ji4,2Tj0 A/
f.
*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
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Electrician Plumber Mechanical 17'1 / 5 / 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: /
Print Name: R Is /�7�f iT-S Signature r/�!� Date
Revision date 216;2017