HomeMy WebLinkAbout4432 S COLLEGE AVE - APPLICATIONS - 6/12/2018 (5)City of
Fort Collins
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Planning, Development & Transportation
281 N College Ave P O Box 580 ���� 10
Fort Collins, CO 80524 70
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) V'Air Conditioning J9 I -�!'q
❑ 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 v�g
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified provide make model and
manufacturer) /�j
Complete all applira �e,lnfor ion on the ��� 13t7 Inc Rm� leapplications anrill not be accepted
Application # 81J ?Oq_38(f IgO�vB - ,, Date " ► �� ��� ��
For office use only l go
Job Site Address (required)
Value of Construction (labor, materials, profit)
Property Owner Name
Address City/State Zip
Phone
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Applicant Name
Address City/State Zip
Phone
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Contractor
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Address City/State Zip
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Phone
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Contractor City of Ft Collins Sales Tax # Are you paying taxes here or by report? ❑ Here ❑ Report
Sales tax number Is required by all contractors Are you paying with your trust account? ❑ Yes
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❑ No
Is this a residential or commercial project? ❑ Residential RS 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 WNo If yes, you may need to contact Histonc Preservation
If this is for a demolition permit, what year was the building constructed?
If pnor to 1975, you wrll need an asbestos assessment to submit with this application
Description of work [ %%G;= . c=o c_��— 2��c.c� _rn�.-� . of C`T�ZTJ�S
*If lawn sprinkler/backflow preventer, must list licensed plumber If first-time A/C, must list license electrician
Subcontractors List the company name or Gty of Ft Collins license #
Electrician Plumber.
Mechanical 3Lk y - " 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 1�04&4 Signature Date _(0/[11 16
Community Development & Neighborhood Services
281 North College Avenue
Fort Collins 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 -top equipment and furnaces
,K 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
3 All equipment/appliances must be installed in compliance with 2009 IMC, IFGC, IPC, and
2011 NEC
6 /11 / [,!?-,
Appli,,Wsignature and date
(Form updated 1-18-2013)