HomeMy WebLinkAbout830 Bitterbrush Ln - Applications/Air Conditioner - 04/02/2019City of Planning, Development & Transportation Services
Fort COiIInS Community Development & Neighborhood Services
281 North College Avenue
Fort Collins, CO 8=4 Main: 970.4162740 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 applyWAir Conditioning
❑ Demolition (interior non-structural) 0 Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Wafer Line ❑ Wooffell i Stove (mast be EPA certified, provide make, model and
manufacturer).
Complete all applicable innfformation on the application. Incomplete applications will not be accepted.
Application # l I Date April 2, 2019
aflrco rae only
Sob Site Address (ra°quked) Value of Construction (labor, materials, profit)
830 Bitterbrush Lane, Fort Collins, CO 80526 $6350.00
Property Owner Name Address city/State Zip Phone
Jeremiah Stilson 830 Bitterbrush L Ft Collins, CO 80526 970-294-2764
Applicant Name Address City/State Zip Phone
Christina Evans 1015 Link Lane Ft Co, CO 80524 494-7632
Contractor Address City/State Tip Phone
Allen Service 1015 Link Lane Ft Co, CO 80524 4844841
Contractor City of Ft Collins Sales Tax # Are you paying taxes here or by report? ❑ ere ❑ Report
SWstarnwnber®v*Wbyaflconbadbrs Are you paying with your trust account? VYes ❑ No
10010
is this a residential or 9mimercial project? itResidential ❑ Camnrerwl
If residential, is it: V Single Family Detached 17 Condo/townhome (single family attached) ❑ Duplex
0 Multifamily (apartment) 0 Garage
If commercial, is it: ❑ Bank 0 Bar 0 Church ❑ Hotel/Motel ❑ Medial office ❑ Office ❑ Retail
❑ Restaurant 17 Other (e(plain)
Is this building So years of age or more? ❑ Yes ❑ No Ifya* yaw mayiwed tv cnnt?d h%tu& Aeswvdbbn
If this is for a demolition permit, what year was the building constructed?
Description of work R Y exMiN AC and replace with 17m new AC
I
*If lawn sprtnider/bacUlDw preventer, must list 5oaued plumber. If fusfi-time A/C, must list licensed electrician.
subcontractors List the mmpanyeameorGlyvfFtCaffns&mw0
Hed ddwk Plumber Medmr&W Roofer Other
I hereby admowtedge that I have read this application and state that the above information is complete and correcL 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,Appl
Printr Name: Chri6iE+uv£va wS Signature �11 u u () I U! I1N (illU �fl /J Date �� �z