HomeMy WebLinkAbout4809 S COLLEGE AVE - APPLICATIONS - 6/17/2019i1S Planning, Development, & Transportation Services
Community Development & Neighborhood Services
281 North College Avenue
Fort Collins, CO 80524 Main: 970.416.2740 Fax: 970.224.QI34
OVER-THE-COUNTER PERMITS ONLY
This appli a Ion is to be used to apply for the following permits only (check all that apply). El Air Conditioning
❑ Demolit, n (interior non-structural) ❑ Electrical Alteration (not service change) El Gas Lighter ❑ Gas Log
El Heating' Lit it ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofings ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilat n ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacty en.
Complete all, applicable information on the ap>�cation. Incomplete applications will not be accepted.
Applicati5 n # 6 (J�pZ Date V7-
For office use only
Job Site q dc ress (requlred) Value of cons uction labor, materials,
e_ cprofit)
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Property 0', n r Name Address
i 1 Y ICJ O �i City/State Zip Phone
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1 Y O,CCU 4 4PW- f5!
Applicant iN 6ri a Addresgg C'ty/State Zi
lnlnu.n' :...111 ntil:..._t,. �:- I� _d � P Phone
Contractor V Address City/5t Zip Phone CRI
v -
Contractor pity of Ft. Collins Sa s Tax # Are you
sales taxnum,, er�isrequlredbyallcontractoi-s, o t0� y Paying taxeslhere or by report? ❑Here ❑Report
1 -T xx Are you paying with your trust account? ❑ Yes ❑ No
Is this a res, lehtial or commercial project? ❑ Residential Commercial
If residentiaj ! is it: ❑ Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercl{ ,I, it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office Retail
❑ Restaurant ❑ Other (explain)
Is this buildil g 150 years of age or more? ❑ Yes ❑ No Ifyes, you mayneed toicontact /yistoricpreseruation
If this is for demolition permit, what year was the building constructed?
Description
*If lawn sprit le�/backFlow preventer, must list licensed plumber. If first-time A/C,1 must list licensed electrician.
Subcontract l r4: List the company name or City of Ft Collins license #
ill
Electrician_ Plumber
Mechanical Roofer _, Other _
I hereby ackn `wedge that I have read this application and state that the above informs complete and correct. I agree to
comply with a requirements contained herein and city ordinances and state laws regulating building construction. I know that a
it is o
permnvalid until it has been paid and Issued.
i
Applicant:
Print Name 1 `1 Signature 1 1 A
Date f
Revision date 2/612m71
C.i,=1 ,¢ Community Development & Neighborhood Services
} 281 North College Avenue
®r 1. COLitn s Fort Collins, CO 80524
970,416.2740
Over the counter permit info sheet for -
New and ren/acement h vac roof -top equiament, furnaces and water
heaters
The following information must be included to approve the permit. Check all that apply,
1. Roof -top equipment and furnaces;
Replacement of existing equipment,
❑ New/additional roof -top equipment.
Equipment is the same weight ord9)an(9 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.
)k 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.
pl 1 Y 1C1���lJl �l
Appll&nt-signature and 6ate
(Form updated 1-18-2013)