HomeMy WebLinkAbout4213 NEW HAMPTON CT - APPLICATIONS - 6/26/2018City of Planning, Development, & Transportation Services
Fort Collins Community Development & Neighborhood Services
281 North College Avenue
Fort Collins, CO 80524 970.416.2740
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
❑ 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 information on the application. Incomplete applications will not be accepted.
Application # T7 19 04 zS`(00 4Date
For office use only
Job Site Address (required) Value of Construction (labor, materials, profit)
4213 New Hampton Ct. Fort Collins, CO 80525 $6000
Property Owner Name Address City/State Zip Phone
Debra & Don Schofield 4213 New Hampton Ct. Fort Collins, CO 80525 970-217-3578
Applicant Name Address City/State Zip Phone
One Hour Heating & Air 5400 N Garfield Ave Unit A Loveland 80538 970-775-7005
Contractor Address City/State Zip Phone
One Hour Heating & Air 5400 N Garfield Ave Unit A Loveland 80538 970-775-7005
Contractor City of Ft. Collins Sales Tax Are you paying taxes here or by report? I�kHere ❑ Report
5ales tax number is required by all contractors. Are you paying with your trust account? RYes ❑ No
Is this a residential or commercial project? C3(Residential ❑ Commercial
If residential, is it: IXSingle 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 ❑ 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 Replace 14seer 3.5ton AC and Coil
*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 Plumber Mechanical H-824 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: Ashley Wehunt Signature ()aZ4tZ- Date 6/20/2018
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