HomeMy WebLinkAbout2114 Mainsail Dr - Applications/Air Conditioner - 07/17/2019Planning, Development D Transportation
281 N. College Ave P.O. Box 580
Fort CoWrIs, CID 80524
Phone 970-116-2740 Fax 224604
OVER-THE-COUNTER PERMITS ONLY
a Deemoidwatii ion I ior�iw treed teapply for the rel O IAlterationfollowingper is only
(check all that apply). o Air Conditioning
( ) O Gas Lighter O Gas Log
O Heating Unit 0 Lawn Sprinider O Mobile Home replacement 0 Roofing O Sewer Line 0 Phob-voltaic
O Ventilation O Water Heater 17 Water Wre 17 WooditM Stove (must be EPA certified, provide make, model and
manuiadurer).
Complete all applicable information on the application. Incomplete applications will not be accepted.
Applicab m # B � Cl -
Fwafte ime harry
Date
lob SRO Addn m if.
Value of Cora trudlon (labor, materfs, proflt)
Property Owner Name Address
Clty/State 21p Phone
L
dZ,�W / -230-3N9,
Applicant Name Address
City/State Zip Phone
Cor&aCbor Address
Gty/Stabs Zip Phone
Contractor City of Ft Collins Sales Tax p
Are you paying taxes here or by report? )B( Here O Report
saFsr�r ,,e!braPm►,�tas
Are you paying with your bug account? O YesNo
Is this a residential camrnerclW project? cientiaal 0 Commercal
If residential, IS it: ngie Family Detached O Carrdo/tovmhome (single family attached) O Duplex
0 * (apart) 0 Garage
If commercial, is It: 0 Bank 0 Bar O Church i] HoWmotel E3 Medical office 17 Office 13 Retall
0 Restaurant 13 Other (explain)
is this building 60 years of age or mare? ores O No Ifyhes, you miay need to cnnbd HLvwk Praehervagon
If this Is for a demolition permit what year was the building constructed?
Ifpr1hrto 1975,, you wf//need an asbesft azewnwt to ar&,)dt ► a "apin%2t'on.
Description of work
V lawn HhrlNder/baddlow preventer, must PA licensed plumber. If first-time AfC, must list licensed eledridan.
SubomMractors: L&MecompwnameorC3tyofRawmas/k>?rmav
Betiri Phmber MedhaNral Roofer Other
I hereby acbawledge 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 brat a
permit is not valid until It has been paid and Issued.
Applicant: ,�A , - ./
Print Name: � C1y �Q.i.[��Slgnature PL41 A Oi a.1l A � / Date11
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