HomeMy WebLinkAbout423 FRANKLIN ST - APPLICATIONS - 7/30/2019Fort Collins
Planning, Development & Transportation
281 N. College' Ave P.O. Box 580
Fort Collins, CO 80524
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). M Air Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit C] Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line 0 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 # fv1 l _D&0b3 Date
For ofce use only
7/30/2019
Sob Site Address (regWred)
Value of Construction (labor, materials, profit)
423 Franklin St.
$ 3287.00
Property Owner Name Address
City/State Zip
Phone
Jack Armstrong 423 Franklin St.
Fort Collins, CO 80521
493-3272
Applicant Name Address
City/State Zip
Phone
Darrow Clark 1314 Webster Avenue
Fort Collins, CO 80524
493-3272
Contractor Address
City/State Zip
Phone
DC Shortridge dba Gary He 1314 Webster Avenue
Fort Collins, CO 80524
493-3272
Contractor City of Ft Collins Sales Tax #
Are you paying taxes here or by report?
O Here ❑ Report
Sales tax number is required by allconrractom
Are you paying with your trust account?
0 Yes ❑ No
34734
Is this a residential or commercial project? O Residential 0 Commercial
If residential, is it: O Single Family Detached 0 Condo/townhome (single family attached) P Duplex
0 Multifamily (apartment) 91 Garage
If commercial, is it: 0 Bank 0 Bar 0 Church 0 Hotel/Motel 13 Medical office 0 Office 0 Retail
0 Restaurant 0 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 w/11 need an asbestos assessment to submit with this application.
Description of work Install new 24on. 13seer AC system
*If lawn sprinkler/backfiow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or C/ty of Ft Collins license #
ElectricianA&M Electric Plumber Mechanical H-1654 Roofer
Other
I hereby acknowledge thatI 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. I— G®�Ys9 aE by 9SW btJo
Dennis'(,-, ;a, m`�„
gmeApplicant Dennis Shortridge Shortridge'= ` �s:�m4s 7/30/2019
Print Name: Signature Date