HomeMy WebLinkAbout1512 Teakwood Ct - Applications/Air Conditioner - 07/30/2019FCity of planning, Development,, & Transportation Services
&t lins Community Development & Neighborhood Services
281 North College 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 (ihrterior 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(Peliet Stave (must be EPA certified. provide make, model and
manufacturer).
Complete all applicable information an the application. Incomplete applications will not be accepted.
Application # ?) OS9DI-�P
rerGNU-- me only
Date July 30, 2019
Job Site Address (squad) Value of ConsteucUon (labor, materials, profit)
1512 Teakwood Ct, Fort Collins, Colorado 80525 $8750.00
Property Owner Name Address City/State Zip Phone
band Abbey 1512 Teakwood Ct Fort Collins, CO 80525 970-214-3345
Applicant Name Address City/state Zip Phone
Christina Evans 1015 Link Lane Ft Co, CO 80524 494-7632
Contractor Address city/State zipp Phone
Allen Service 1015 Link Lane Ft Co, CO 80524 484-4841
Contractor City of FL Collins Sales Tax # Are you paying taxes here or by report? ❑Mere ❑ Report
S?resrarmffnbertstagz*&byarlcmbacmm Are you paying with your trust account? VYes ❑ No
10010
is this a residential or qpnmeicial project? Residential ❑ Commercial
if residential, is it: `® Single Family Detached ❑ Condo/bownhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 5o years of age or more? ❑ Yes ❑ No Yyzs, you nmyneed to mntactH&tui c Presanrahbn
If this is for a demolition permit, what year was the building constructed?
Description of work P� vd"nq AC UM rePww with she � AC
*If lawn sprinkleribackilow preventer, must fist licensed plumber. If first-time A/C mast list licensed eleetridan.
Subcontractors: List MecompanynameorOWofFtCnDins%0
Sertridar Plumber Medhankal Roarer 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. // y�� p , C J
Applicant: Chai�tivux.Fvarh4 g t /t r r [ ( 1 tf�l&MIN Date
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Print Name; Si nature
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