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Home My WebLink About2057 Vermont Dr - Applications/Mechanical - 03/12/2019 (7)Ciof Flirt Collins 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 non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Light ❑ Gas Log leating 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 a cept d. Application # Ig61ySo go(4s1/M6145Z jalgdl4:01g,1614s4184669sS1�1�6�gs�76f9a/457 For office use only OW604TV6116945f 606/460 10%-7 Sob Site Address (required) Value of Construction (labor, materials, profit) d0s-7 VC? inw i a A,?rl Co , ,?o.r.ud $ 06// 9a- oLcl eac k Property Owner Name Address City/State Zip Phone ci Applicant Name Address City/State Zip Phone', l'o woing J, rn ) Y/6 A /i 4/� lona' Co eo e'6PS.? ` 97 a - �1 y� -2o c`-21 Contractor Lic # Address City/State Zip Phone S MA Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by repo Her eport Sales tax number Is required by all contractors Are you paying with your trust account. s to J b" 12, %.ice Is this a residential or commercial project? ❑ Residential If residential, is it: ❑ Single Family Detached ❑ Condo/ owr ❑ Multifamily (apartment) ❑ Garage (single family attached) ❑ Duplex If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel . ❑ Medical office �Wffice ❑ Retail ❑ Restaurant ❑ Other (explain) Is this building 50 years of age or more? ❑ Yes )lo 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 will need an asbestos assessment to submit with this application. Description of work *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 Plumber Mechanical I 1/� 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: W/ // /Mti Signat � Date City of Community Development & Neighborhood Services 281 North College Avenue Fort Collins Fort Collins, CO 80524 !n� 970.415.2740 BI gDi4sa 13(g6i4sl%(�Iof4sz/B`ger4s3/graoi4s4)8ll6tl5Z5-/Slg6/4%/Bf9o/4s' glgol4s$1 ai961451 I isMI &O Over the counter permit info sheet for. - New and rep/acement hvac roof -too eauiument, furnaces, and water heaters The following information must be included to approve the permit. Check all that apply. 1. Roof -top equipment and furnaces: N In Replacement of existing equipment. ❑ New/additional roof -top equipment. Equipment is the same weight or lighter and similar or smaller size/footprint. ❑ Equipment is heavier and will provide engineered documentation showing roof can support new equipment or modifications that must be done to support such equipment. Replacement equipment is in the same location and not taller than previous. ❑ Replacement equipment is in new location and/or taller. ❑ For New equipment. See attached engineered documentation showing roof can support new equipment or modifications that must be done to support such equipment. ❑ Ground or floor mounted. 2. Hot Water Heater: ❑ Replacement ❑ New ❑ Same size or smaller than previous. ❑ Larger than previous water heater. ❑ If for a restaurant I have approval from Larimer County Health Dept for minimum water heater capacity. 3. All equipment/appliances must be installed in compliance with 2009 IMC, IFGC, IPC, and 2011 NEC. Applicant signature and date (Form updated 1-18-2013)