HomeMy WebLinkAbout331 SUNDANCE CIR - APPLICATIONS - 4/5/2019City of Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Flirt Colons Fort Collins, CO 80524
1111� 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). 0 Air Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
O Heating Unit ❑ Lawn Sprinkler ❑ ivlobile 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 # S l" 1 l) L I (,p Date
For office use only
4/5/2019
Sob Site Address (required)
Value of Construction (labor, materials, profit)
331 Sundance Cir. Unit-C
$ 4815.00
Property Owner Name Address
City/State Zip
Phone
331 SUNDANCE LLC 1000 DRIFTWOOD DR STE A FortCollins, CO 80525
493-3272
Applicant Name Address
City/State Zip
Phone
331 SUNDANCE LLC 1000 DRIFTWOOD DR STE A FortCollins, CO 80525
493-3272
Contractor Address
City/State Zip
Phone
DC Shortridge dba Gary Hil 1314 Webster Avenue
Fort Collins, CO 80524
493-3272
Contractor City of Ft Collins Sales Tax #
Are you paying taxes here or by report?
El Here ❑ Report
Sales tax numbarisrequired byall conrracrnrs:
Are you paying with your trust account?
O Yes ❑ No
34734
Is this a residential or commercial project? O Residential ❑ Commercial
If residential, is it ❑ Single Family Detached 111 Condo/townhome (single family attached) 9 Dupiex
G Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank 0 Bar ❑ Church 0 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?
Ifpnor to 1975, you wf//need an asbestos assessment to submit with this appl>cablon.
Description of work _ Replacing heat pump with a 2.5-ton. 13SEER unit.
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-dme A/C, must list licensed electrician.
Subcontractors: Ust the company name or City of Ft Collins license #
Hectridan Plumber Mechanical H-1654 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. (" o;�,N�, e,,,�� s„a„�,pa
1; ;s ®ae,e; g:�q R�Oevs
Dennis
� ` \Real e8reeb epevfieE parts altlu.
Applicant: Shortridg
Signature °°�°e=aamn:`i
Print Name:
Dennis Shortridge s_�a�sDate
ue 4/5/2019