HomeMy WebLinkAbout5620 Fossil Creek Pkwy - Permits/Air Conditioner - 07/31/2020 (14)Owner: SHIELDS SUSAN W
777 N SHORE DR STE
SOUTH HAVEN, MI 49090-9022 Phone: 90-282-8281
Zoning: Front setback: Rear setback: Right setback: Left setback:
Minor Amend #: Plat File #: ZBA Case #:
Zoning district: LMN - LOW DENSITY MIXED-USE NEIGHBORHOOD DISTRICT
Legal: Subdivision/PUD: Filing #: Lot #: 107 Block #: 11
Code: Res sq ft: Com sq ft: Ind sq ft: Basement sq ft:
# of stories: Occ Group: Const Type:
Fire Sprklr: Stock plan #: Stock plan options:
Contractor: RSTART, LLC DBA PLANET ROOFING AND
SOLAR
8765 E. Orchard Rd. Suite 703
Greenwood Village, CO 80111
License #: H-3982(RR)
Phone: 303-827-1607
Supervisor cert #:
Subcontractor(s) Phone License Number
Mechanical: RSTART, LLC DBA PLANET ROO 303-827-1607 H-3982(RR)
Work Description: Replace air conditioner/condenser.
SCHEDULE INSPECTIONS: ** via Text Message: 888-406-6394 ** By Phone: 970-221-6769
** Online Portal: fcgov.com/CitizenAccess ** Online Portal via Mobile Device: fcgov.com/CitizenAccess/mobile
Possible Inspections Required: 204 302 300 301
TOTAL FEES PAID AS OF 07/31/20: $59.88 Payment method: Trust Account
** Fee Detail Displayed on Next Page
As a condition for the issuance of a permit, I hereby declare that I am the ownerorowner'sagent,authorized to perform the proposed workonthepropertydescribedherein.
I agree to comply with all the requirements contained herein, and City ordinances, and State lawsassociatedwithsuchwork. I understand that suchpermitmaybe
revoked in the event that issuance was basedonincorrectinformation. This permit shall become null and void if the workauthorizedbysuchpermitisnotcommenced,
suspended, abandoned or not inspected within 180 days fromthedateofsuchpermit.
Carbon Monoxide Alarm required within 15 feet of each bedroom entrance.
Community Development & Neighborhood Services
281 N. College Ave Fort Collins, CO 80522
970.221.6760 970.224.6134 - fax
Building Permit #: B2008674
Issued Full: 07/31/2020
Permit Type: Residential Mechanical
Site Address: 5620 FOSSIL CREEK PKWY, 11 107
Job Valuation: $1,500.00 Category: Residential
Signature: Print Name: Date:
Form Revised Oct 2010
Transactions
Method Check Number Date Paid Amount Paid Comments
Trust Account 07/31/2020 $59.88
Receipt issued: 07/31/2020 Total Paid to Date: $59.88
Fee Description Account Code Fee Amount Amount Paid Date Paid Amount Due
City Sales/Use Tax 251.122030 $28.88 $28.88 07/31/2020 $0.00
County Sales/Use Tax 100.217030 $6.00 $6.00 07/31/2020 $0.00
Permit Flat Fee w/o Subs $25 1000.422010 $25.00 $25.00 07/31/2020 $0.00
TOTAL FEES: $59.88 $59.88 $0.00
TOTAL BALANCE DUE AS OF 07/31/2020: $0.00
Community Development & Neighborhood Services
281 N. College Ave Fort Collins, CO 80522
970.221.6760 970.224.6134 - fax
Building Permit #: B2008674
Issued Full: 07/31/2020
Permit Type: Residential Mechanical
Site Address: 5620 FOSSIL CREEK PKWY, 11 107
Job Valuation: $1,500.00 Category: Residential
Fee Amounts are valid for date of this document only. Fees subject to change without notice.
Form Revised Oct 2010
Application # _____________________________
Date Received ___________________________
RESIDENTIAL WATER HEATER &
HVAC PERMIT APPLICATION
ALL information is REQUIRED. Incomplete applications will not be accepted.
Job Site Address
Address ________________________________________________________________ City/State/Zip _________________________
Property Owner Information
Name ______________________________________________________ Phone Number _____________________________________
Address ________________________________________________________________ City/State/Zip _________________________
Scope of Work
Air Conditioner
Furnace
Minisplit
Boiler
Water Heater
Other: __________________
New Install Replacement
Description Valuation
(per appliance) Description
Valuation
(per appliance)
1. 1.
2. 2.
3. 3.
4. 4.
5. 5.
6. 6.
7. 7.
8. 8.
9. 9.
10. 10.
Contractor Information
Name ________________________________________________________________________________________________________
Company ______________________________________________________________
License Holder ____________________________________ License Number ______________________________________
Electrical Contractor Information (only required for first time AC install)
Name ________________________________________________________________________________________________________
Company _________________________________________________ License Number ME- _____________________________
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.
Print Name Signature Date
Community Development and Neighborhood Services
281 N College
Fort Collins, CO 80524
buildingservices@fcgov.com
970-416-2740
5620 Fossil Creek Pkwy Fort Collins CO 80525
Ian Armstrong
RSTART, LLC DBA Planet Roofing and Solar
Ian Armstrong H-3982(RR)
Ian Armstrong 07/08/2020
970.282.8281
A/C CONDENSOR SWAP 1500.00
# 11107
SHIELDS SUSAN W
777 N SHORE DR SOUTH HAVEN, MI 49090