HomeMy WebLinkAbout4560 Larkbunting Dr - Applications/Air Conditioner - 06/07/2019City(A planning, Developmen4 & Transporialion Services
Fort Collins Community Development & Neighborhood Services
281 North Cottage Avenue
Fort Collins, CO 80524 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 apply).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 e application. Incomplete applications Will not be accepted.
Application # 1 �044 ' Date June 7, 2019
For offi a im a*
Job Site Address (repulrad) Value of Construction (labor, materials, profit)
4560 Larkbunting Dr A8, Fort Collins, Colorado 80526 $7914.00
Property Owner Name Address city/State Zip Phone
Sandra Reese 4560 Larkbunting Dr #8-A Ft Collins, CO 80526 970-413-1333
Applicant Name Address City/State Zipp Phone
Christina Evans 1015 Link Lane Ft Co, CO 80524 494-7632
Contractor Address aty/stage Zpp Phone
Allen Service 1015 Link Lary: Ft Co, CO 80524 484-4841
Gxntrador City of FL Collins Sales Tax # Are you paying taxes here or by neport7 ❑Mere ❑ Report
Saks &rnwnberbreoedbyagamhaaftm Are you paying with your trust account? VYes ❑ No
10010
Is this a residential or inmerdal project? ItResidentlal ❑ Commercial
If residential, is it; V Single Family Detached ❑ Condo/t ownhome (single family attached) ❑ Duplex
❑ Multi€amiy (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this buikrmg 50 years of age or more? ❑ Yes ❑ hlo Ifyes, you mayneed to cont=tfflsl &Preserr ilm
If this is for a demolition permit, what year was the building constructed?
DescripUcin of work Remove exiOng AC and mpke oath rke rev AC
*If lawn sprinlder/baddlow preverter, must list licensed plumber. If first-time A/C, must list licensed electrician.
subcontractors: iBtMemmAwynanrearGlyofaCaWnsCbwse#
9eotridmt plumber Merhankal Router other
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I hereby acknowledge that I have read this application and slate that the above information Is complete and correct. I agree to
campy with all requirements contained herein and city ordinances and state laws regulating building oons"clion. I know that a
permit is not valid urfil it has been paid and issued. ��j / [� t Q Applicant: CYu ibLinwEvan6 l/r � `ia ILl c�l/t tp t,o " h t 1
Print Name: Signature tlabe
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