HomeMy WebLinkAbout6126 CRANE DR - APPLICATIONS - 12/9/2019C,Ciity, of Planning, Development & Transportation Services
F-cJr� Cd1ins Community Development & Neighborhood Services
281 North College Avenue
Fort Collins, CO 80524 Main: 970.4162740 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 Light fi Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ WoodIPellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application #
forolTrce rye a*
Date December 6, 2019
Job Site Address (regwrad) Value of Construction (labor, materials, profit)
6126 Crane Drive, Ft Collins, Colorado 80528 $7350.00
Property Owner Name Address City/State 71p Phone
David Kissel 6126 Crane Drive Fort Collins, CO 80528 970-207-1560
Applicant Name Address City/State zip Phone
Christina Evans 1015 Link Lane Ft Co, CO 80524 494-7632
Contractor Address Clty/State zip Phone
Allen Service 1015 Link Lane Ft Co, CO 80524 484-4841
Contractor City of Ft Collins Sales Tax # Are you paying taxes here or by report? ❑ jiere ❑ Report
Safes tartumber& n4tded6ya9awoac*m Are you paying with your trust accaunt? w'es ❑ No
10010
Is this a residential or Wrnmetcial project? Residential ❑ Commercial
If residential, is it `® Single Family Detached ❑ Condo/brnmhmne (single family attached) ❑ Duplex
❑ Multifamiy (aparbnent) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hatel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes ❑ No Ifyes,, you may need to mnta&h%to c Plesatabbn
If this is for a demolition perrm't, what year was the building constructed?
IPescrlption of work P " f Sti g AC and reply Uth men Eke AC
*If lawn sprinider/bacidfow'preventer, must IM Greased plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List Me mr wmyname orGlyofftCoAns&ffie #
8eMidw Plumber Merhankal Raafer Other
I hereby acknowledge that I have read this application and state that the above information is complete and correct I agree to
compy with all requirements contained herefn and city ordinances and state laws regulating buiding construction. I know that a
permit is not valid until it has been paid and issued. ( /� r
Print Name: C i6tcraFvctvt4 Sig re LI wt V IM6C� Date