Loading...
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 - 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 dge ==7