HomeMy WebLinkAbout5620 Fossil Creek Pkwy - Applications/Mechanical - 07/28/2020Frt Collins
Community Development and Neighborhood Services
281 N College buildingservices@fcgov.com
Fort Collins, CO 80524 970-416-2740
Job Site Add
Address
Property Owner
ff
Name ftwl a
Scope of Work
Air Conditioner
Q Furnace
Q Minispld
Q Boiler
uescrtpnon
(per appliance)
2.
15.
Contractor Information
Name f awl
Application # (2(n !% 4S-
Date Received In4Z�'7,626
Phone Number
City/State/Zip �^?�� COIJ(il
City/State/Zipl2 (!".t�i k-3 0 .fl]S2�
Q Water Heater
Q Other:
Replacement
Description Valuation
(per appliance)
.
3.
4.
16.
17.
18.
Company I /fl�;l� 1-/O/-1 F IZIL(V%I Y 9X7LU
License Holder I", (V-J hocrq
Electrical Contractor Information (only required for first time AC install)
Name
Company
,: rwd So
License Number 1- — 3gg7—La
License Number ME -
Print Name Signature �[/� /�% Date