HomeMy WebLinkAbout602 KIM DR - APPLICATIONS - 8/7/2018 (2)Fcity of Planning, Development, & Transportation Services
it WtinS Community Development & Neighborhood Services
281 North College Avenue
Fort Collins, CO 80524 Main: 970.416.2740 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 Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line 0 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 # 16 y b o(� S 3� Date
For ofte use only
lob Site Address (required) Value of fiction (labor, materials, profit)
a r —Jlj1lt
P perty er Name Address City/State Zip Phone
As
Applicant Name Address City/state Zip Phone
Fort Collins Heating & Air 208 Commerce Dr. #4 Fort Collins, CO 80524 970.484.4552
Contractor Address City/State Zip Phone
For Collins Heating & Air 208 Commerce Dr. #4 Fort Collins, CO 80524 970.484.4552
Contractor City of R. Collins Sales Tax # Are you paying taxes here or by report? ❑ Here ■ Report
sale' tax mm'derIsrepwredbya#conoaaax Are you paying with your trust account? ■ Yes ❑ No
Is this a residential or commercial project? ■ Residential ❑ Commercial
If residential, Is It: 9 Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is It: ❑ Bank ❑ Bar ❑ Church ❑ Hotelfttd ❑ 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 H6tor/c Preseivabon
If this is for a demolition permit, what year was the building constructed?
Description of work
*If lawn sprinkler/backflow, preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: Ust the company name or Py ofRChNns & vnse #
Electridan Murrib Mechanical 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 building construction. I Imow that a
permit is not valid until it has been paid and Issued.
Applicant -
Print 1
Name: U Signature Date
R"ISI nWeZ 2017