HomeMy WebLinkAbout915 THORNHILL PL - APPLICATIONS - 6/17/2019City of Planning, Development, & Transportation Services
Fort Collins Community Development & Neighborhood Services
f 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 ❑ 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 # lJ I q Date
For office use only
Job Site Address (required) Value of Construction (labor, materials, profit)
CM \ %M &� \
Property Owner Name Address Ci tate Zip Phone U11->,
Applicant Name Address City/State Zip Phone
Fort Collins Heating and Air 308 Commerce Dr Fort Collins/ CO 80524 970-484-4552
Contractor Address City/State Zip Phone
Fort Collins Heating and Air 308 Commerce Dr Fort Collins/ CO 80524 970-484-4552
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 ❑ No
060206-024
Is this a residential or mmercial project? bkesidential ❑ Commercial
If residential, is it: Single Family Detached ❑ Cando/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (expl in)
Is this building 50 years of age or more? ❑ YesNo 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
*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 9
Electrician Plumber MP-937 Mechanical 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: �� 1
Print Name: Jennifer Calderon Signature Je + Ifie Date I
Revision dale 2182017