HomeMy WebLinkAbout6020 HUNTINGTON HILLS DR - APPLICATIONS - 10/10/2017Ci ty of Planning, Development, & Transportation Services
.F W[Ins Community Development & Neighborhood Services
281 North College Avenue
Fort Collins, CO 80524 Main 970 416 2740 Fax 970 224 el34
OVER-THE-COUNTER PERMITS ONLY
This application is to be used to apply for the following permits only (check all that apply). ❑ Arc Conditioning
❑ Demolition (interior non-structural) ❑ Electncal Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
14 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 informations on the application. Incomplete applications will not be accepted
Application # bm � A 13 Date
For ofte use only
lob Site Address (required) `� Value of ConstnucM�n (labor, materials, profit)
Property Owner Name Address City ZIp Phone qJ6
Ian
Applicant Name Address City/State Zip Phone
Fort Collins Healing & Air 208 Commerce Dr #4 Fort Collins, CO 80524 970 484 4552
Contractor Address Gty/State Zip Phone
Fort Collins Heating & Air 208 Commerce Or #4 Fort Collins, CO 80524 970 484,4652
Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? ❑ Here � Report
Sales tax numberIsrequlredbya#cvnbazinrs Are you paying with your trust account? 0 Yes ❑ No
Is this a residential or commercial protect? t4 Residential ❑ Commercial
If residential, is It, Single Family Detached ❑ Cando/townhorne (single family attached) ❑ Duplex
Multifamily (apartment) ❑ Garage
If commerdal, is it ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes j$No If yes, you may need to contact Hlstonc Pre- amatron
If this is for a demolition permit, what year was the building constructed?
Description of work
*If lawn sprinkler/badAlow preventer, must list licensed plumber If first-time A/C, must list licensed electrician.
Subcontractors: L& the company name or City of Collins lrcense #
Eiearidan Plumber MechanicaU 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 budding construction. I know that a
permit is not valid until it has been paid and issued.
Applicant: I C(1�
Print Name. tl-) Signature Date
RGYWMdale2 2O17