HomeMy WebLinkAbout6020 HUNTINGTON HILLS DR - APPLICATIONS - 10/4/2017 (2)FCity of Planning, Development, & Transportation Services
ort Collins Community Development & Neighborhood Services
281 North College Avenue
Fort Collins, CO 80524 Main: 970.416.2740 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 (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
14 Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photovoltaic
❑ 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 # R I Date
Forofli'ce use only
Sob Site Address (requlred) ` Value of Construction (labor, materials, profit)
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Property Owner Name Address Gty MakM
Zip Phone QIC
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Applicant Name Address ' qty/State Zip Phone
Fort Collins Heating & Air 208 Commerce Dr. #4 Fort Collins, CO 80524 970.484.4552
Contractor Address City/State Zip Phone
Fort Collins Heating & Air 208 Commerce Dr. #4 Fort Collins, CO 80524 970.484.4552
Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? ❑ Here � Report
Sales tax number isrequiredayall contractors. Are you paying with your trust account? 4 Yes ❑ No
Is this a residential or commercial project? 14 Residential ❑ Commercial
If residential, is it: Single Family Detached ❑ Condo/townhome (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 50 years of age or more? ❑ Yes V No If yes, you may need ro contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
Description of work
*If lawn sprinkler/baddlow preventer, must list licensed plumber. If first-time A/c, must list licensed electrician.
Subcontractors: List the company name or City of Ft Collins license 0
Electrician Plumber Mechanical H1309 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.
Applicant: *thM4 Print NameSignature C Date 1
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