HomeMy WebLinkAbout2412 Sunstone Dr - Applications/Air Conditioner - 05/31/2019City Of Planning, Development & Transportation
C 281 N. College Ave P.O. Box 580
_! 6rt 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). El 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).
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application # ?J1gb 3d%'A Date
For office use only
5/31 /2019
Job Site Address (required)
Value of Construction (labor, materials, profit)
2412 SUNSTONE DR
$3,770.00
Property Owner Name
Address City/State Zip
Phone
BRYCE & MANDY BERQUIST
2412 SUNSTONE DR, FTC CO 80525
970-402-2187
Applicant 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?
El Here ❑ Report
Sales tax number is required by all contractors.
Are you paying with your trust account?
® Yes ❑ No
26862
Is this a residential or commercial project? O Residential ❑ Commercial
If residential, is it: 0 Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
11 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 19 No Ifyes, you mayneed 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 REPLACE AC
*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 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: KARENA HUNTWORK signature
KARENA
HUNTWORK
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Date 05/31 /2019