HomeMy WebLinkAbout1206 Silk Oak Ct - Applications/Air Conditioner - 08/05/2019Fort 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) D Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
Cl 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 application. Incomplete applications will not be accepted.
Application # Nq (D uo °2o Date 8/2/2019
For office use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
1206 Silk Oak Ct.
$ 3134.00
Property Owner Name Address
City/State Zip
Phone
Beth Huelle 1206 Silk Oak Ct.
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 Hil 1314 Webster Avenue
Fort Collins, CO 80524
493-3272
Contractor City of Ft Collins Sales Tax #
Are you paying taxes here or by report?
0 Here ❑ Report
Sales tax number isrequiredbyall confractors
Are you paying with your trust account?
M Yes ❑ No
34734
Is this a residential or commercial project? M Residential 9 Commercial
If residential, is it: 17 Single Family Detached 8 Condo/townhome (single family attached) B Duplex
0 Multifamily (apartment) 11 Garage
If commercial, is it: 13 Bank 13 Bar ❑ Church 8 Hotel/Motel ❑ Medical office IZI Office C1 Retail
❑ Restaurant ❑ other (explain)
Is this building 50 years of age or more? ❑ Yes ❑ No If yes, 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 application.
Description of work Replacing AC with a 2.5-ton. 13seer
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: Ust the company name or City of Ft Collins license #
Hectddan Plumber Mechanical H-1654 Roofer
Other
1 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.
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Print Name: Signature Date