HomeMy WebLinkAbout4700 MCMURRY AVE - APPLICATIONS - 1/24/2013City/ Of Planning, Development & Transportation
281 N. College Ave P.O. Box 580
F6r't Collins Fort Collins, CO 80524
`.— Phone 970-416-2740 Fax 224-6134 if/
OVER-THE-COUNTER PERMITS ONLY 2j6
This application is to be used to apply for the following permits only (check all that apply). ❑ Air Conditioning
❑ Demolition (interior 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/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applic le information on the application. Incomplete applications will.not be accepted.
Application # Date . 12 1
For offlIce use only
Job Site Address (required) Value of Construction (labor, materials, profit)
9 JOD is ;
Property Owner Name
Address
City/State
SIVy0 Phone
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Applicant Name
Address
City/State
lip
Phone
mo
Contractor
Lic # Address
City/State
Zip
Phone
crA mar Avickmccic
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here'or by report?
❑ Here eport
sales bxnumber i�s required amntracmrs
Are you paying with your trust account?
❑Yes No
Is this a residential or commercial project? ❑ Residential
If residential, is it: ❑ Single Family Detached
❑ Multifamily (apartment)
If commercial, is it: ❑ Bank ❑ Bar ❑ Church
❑ Condo/townhome (single family attached) ❑ Duplex
❑ Garage
❑ Hotel/Motel ❑ Medical office
❑ Restaurant ❑ Other (explain)
Is this building SO 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?
If prior to 1975, you will need an asbestos assessment to submit with this application.
work
40ffice ❑ Retail
*If lawn sprinkler/backfiow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
List the company name of Gty of Ft Coffins license #
Mechanical Roofer
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. 1__�) -
Applicant,: 1 _2
Print NameR" 0
Date I • -I
S
of Community Development & Neighborhood Services
City
Fort_t For North College Avenue
�;v.('��"L CollinsJ Fort Collins, CO 80524
970.416.2740
Over the counter permit info sheet for. -
New and replacement hvac roof -top equipment, furnaces, and water
heaters
The following information must be included to approve the permit. Check all that apply.
1. Roof- op equipment and furnaces:
Replacement of existing equipment.
❑ New/additional roof -top equipment.
* Equipment is the same weight or lighter and similar or smaller size/footprint.
❑ Equipment is heavier and will provide engineered documentation showing roof can
support new equipment or modifications that must be done to support such
equipment.
Replacement equipment is in the same location and not taller than previous.
❑ Replacement equipment is in new location and/or taller.
❑ For New equipment. See attached engineered documentation showing roof can
support new equipment or modifications that must be done to support such
equipment.
❑ Ground or floor mounted.
2. Hot Water Heater:
❑ Replacement
❑ New
❑ Same size or smaller than previous.
❑ Larger than previous water heater.
❑ If for a restaurant I have approval from Larimer County Health Dept for minimum
water heater capacity. I
3. All equipment/appliances must be installed in compliance with 2009 IMC, IFGC, IPC, and
2011
signature and date
(Form updated 1-18-2013)