HomeMy WebLinkAbout6213 EAGLE RIDGE CT - APPLICATIONS - 1/14/2020Fort Collins
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970-416-2740 Fax 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 M Electrical Alteration ❑ Gas Lighter ❑ Gas Log ❑ Heating Unit ❑ Lawn Sprinkler
❑ Mobile Home replacement ❑ Sewer Line ❑ 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 # 17Z00030
For office use only
Date 1/13/2020
Sob Site Address (required)
Value of Construction (labor, materials, profit)
6213 Eagle Ridge Ct., Fort Collins, CO 80525
$1,300
Property Owner Name Address
City/State Zip
Phone
Steve Kommrusch 6213 Eagle Ridge Ct.
Fort Collins, CO 80525
970-581-5933
Applicant Name Address
City/State Zip
Phone
Erin West -Mac Electric 1208 Poplar St.
Johnstown, CO 80534
970-669-2464
Contractor Address
City/State Zip
Phone
Mac Electric 1208 Poplar St.
Johnstown CO 80534
970-669-2464
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
❑ Here M Report
Sales tax number is required by all contractors:
Are you paying with your trust account?
M Yes ❑ No
00038713
Is this a residential or commercial project? ® 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 IN No If yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
Description of work Provide and install 60 amp, 240v circuit in garage for Tesla charging station.
*If lawn sprinkler/backflow 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#
Electrician ME-774 Plumber 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.
Applicant:
Print Name: Erin West Signature
Date 1/13/2020