HomeMy WebLinkAbout2403 Sunburst Dr - Applications/Air Conditioner - 07/06/2019Fort 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). M Air Conditioning
❑ Demolition (interior non-structural) O Electrical Alteration (not service change) ❑ Gas Lighter 17 Gas Log
M Heating Unit ❑ Lawn Sprinkler O Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
C3 Ventilation ❑ Water Heater ❑ Water Line 0 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 # I �0O `r�( Date 7/6/2019 /��4c)
For office use only � /� I „ o4 h (P)
Job Site Address (required)
Value of Construction (labor, materials, profit)
2403 Sunburst Dr.
$ 8048.00
Property Owner Name Address
City/State Zip
Phone
Jeff & Jennifer Gessaman 2403 Sunburst Dr.
Fort Collins, CO 80525
493-3272
Applicant Name Address
City/State Zip
Phone
Darrow Clark 1314 Webster Avenue
Fort Collins, CO 80524
493-3272
Contractor Address
City/State Zip
Phone
DC Shortridge dba Gary HiN 1314 Webster Avenue
Fort Collins, CO 80524
493-3272
Contractor City of FL Collins Sales Tax #
Are you paying taxes here or by report?
17 Here ❑ Report
Sales tax number is required by allconb:B&m.
Are you paying with your trust account?
17 Yes ❑ No
34734
Is this a residential or commercial project? 9 Residential Cl Commercial
If residential, is it: G Single Family Detached 9 Condo/townhome (single family attached) ® Duplex
17 Multifamily (apartment) 8 Garage
If commercial, is it: 91 Bank 9 Bar G Church 9 Hotel/Motel G Medical office 9 Office 17 Retail
G Restaurant G Other (explain)
Is this building 50 years of age or more? ❑ Yes O No If m you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
Ifpnor to 1975, you will need an asbestos assessment to submit with this appllcabyon.
Description of work Replace furnace with a 90k BTU. 80% efficient one. Reoladna AC with a 3-ton 16SEER one
*If lawn sprinkler/backfiow 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 #
Eectridan Plumber Mechanlydl H-1654 Roofer
Other
I hereby acknowledge thatI 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. I--- ZllyipneE by Dem65MNtlpa
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Applicant: ortrid;e: �,o�
Dennis Shortridge r- are:109RUfi,y:R,6 7/6/2019
Print Name: Signature ---� Date _