HomeMy WebLinkAbout4702 DUSTY SAGE DR - 06 - PERMITS - 1/8/2021Owner:POLIS GLORIA W LIVING TRUST
4702 DUSTY SAGE DR UNIT 6
FORT COLLINS,CO 80526-3761 Phone:720-353-2517
Zoning:Front setback:Rear setback:Right setback:Left setback:
Minor Amend #:Plat File #:ZBA Case #:
Zoning district:LMN -LOW DENSITY MIXED-USE NEIGHBORHOOD DISTRICT
Legal:Subdivision/PUD:Filing #:Lot #:Block #:
Code:Res sq ft:Com sq ft:Ind sq ft:Basement sq ft:
#of stories:Occ Group:Const Type:
Fire Sprklr:Stock plan #:Stock plan options:
Contractor:JMP HEAT INC DBA LION HOME SERVICE
4600 Innovation Drive,Ste 102
FORT COLLINS,CO 80525
License #:H-3839
Phone:970-632-5342
Supervisor cert #:
Subcontractor(s)Phone License Number
Mechanical:JMP HEAT INC DBA LION HOME 970-632-5342 H-3839
Work Description:Replace furnace.
SCHEDULE INSPECTIONS:**via Text Message:888-406-6394 **By Phone:970-221-6769
**Online Portal:fcgov.com/CitizenAccess **Online Portal via Mobile Device:fcgov.com/CitizenAccess/mobile
Possible Inspections Required:204 302 300 301
TOTAL FEES PAID AS OF 01/08/21:$212.39 Payment method:Trust Account
**Fee Detail Displayed on Next Page
As a condition for the issuance of a permit,I hereby declare that I am the owner or owner's agent,authorized to perform the proposed work on the property described herein.
I agree to comply with all the requirements contained herein,and City ordinances,and State laws associated with such work.I understand that such permit may be
revoked in the event that issuance was based on incorrect information.This permit shall become null and void if the work authorized by such permit is not commenced,
suspended,abandoned or not inspected within 180 days from the date of such permit.
Carbon Monoxide Alarm required within 15 feet of each bedroom entrance.
Community Development &Neighborhood Services
281 N.College Ave Fort Collins,CO 80522
970.221.6760 970.224.6134 -fax
Building Permit #:B2100155
Issued Full:01/08/2021
Permit Type:Residential Mechanical
Site Address:4702 DUSTY SAGE DR,6
Job Valuation:$6,339.30 Category:Residential
Signature:Print Name:Date:
Form Revised Oct 2010
Transactions
Method Check Number Date Paid Amount Paid Comments
Trust Account 01/08/2021 $212.39
Receipt issued:01/08/2021 Total Paid to Date:$212.39
Fee Description Account Code Fee Amount Amount Paid Date Paid Amount Due
City Sales/Use Tax 251.122030 $122.03 $122.03 01/08/2021 $0.00
County Sales/Use Tax 100.217030 $25.36 $25.36 01/08/2021 $0.00
Permit Flat Fee -$65 1000.422010 $65.00 $65.00 01/08/2021 $0.00
TOTAL FEES:$212.39 $212.39 $0.00
TOTAL BALANCE DUE AS OF 01/08/2021:$0.00
Community Development &Neighborhood Services
281 N.College Ave Fort Collins,CO 80522
970.221.6760 970.224.6134 -fax
Building Permit #:B2100155
Issued Full:01/08/2021
Permit Type:Residential Mechanical
Site Address:4702 DUSTY SAGE DR,6
Job Valuation:$6,339.30 Category:Residential
Fee Amounts are valid for date of this document only.Fees subject to change without notice.
Form Revised Oct 2010
City of ,k;Solli�S
Community Development and Neighborhood Services
281 N College buildingservices@fcgov.com Fort Collins, CO 80524 970-416-2740
WATER HEATER & HVAC PERMIT APPLICATION
Application# __________ _
Date Received
ALL inf ormation is REQUIRED. Inc omplete applications will not be accepted.
Job Site Address
�
Address 4J(JJ'J 0'1\-St"1.S��� 0Y4tlo fi-oVO\,th1S, C,0 8Ql5d"io City/State/Zip-----------
Property Owner Information
Name '1'1 0 r\ (A f Q \A J Phone Number _1..,_.a ..... CO.,___O:w..�5 .... l,..__,• d'--'5 ..... \L-,1'--------
Address 4t@2 Q\,Ut1j �<A�i \)\' :filo (h(A)\/Uns, w 005;}\p City/State/Zip _______ _
Scope of Work 0 Air Conditioner
.Furnace 2. QMinisplit 3.
QBoiler 4.
0 Water Heater 5.
6. Qather 7.
Contractor Information
Name m Q\ (I{� 1/i n '<, (rQ � t t
Company .JvYlP HtM lt\C OB'Yt \Aon ttom'i. -StYViC�
License Holder ---------------License Number
Electrical Contractor Information (only required for new installs)
Name -------------------------------------------
Company License Number ME-------------
Rooftop O Yes O No Note For new rooftop equipment or replacemen ts that are heavier than original, engineered documentation needs to be provided to show roof can support equipment.
Equipment is same weight or lighter
Equipment is in same location
Location
QYes
Oves
QNo
QNo
Equipment is same footprint or smaller Q Yes
Equipment is same height or smaller O Yes
QNo
QNo
If for a water heater or boiler in any food or beverage serving facility/Day Care/Institution occupancies, I have approval from the JLarimer County Health Department for minimum water heater capacity. 0 Yes Q No
I Tenant Name-------------------------------
I hereby acknowledge that I have read ti iis appl1cat1on and state !/1al tile abovf' 1nforrroa11on 1s complete and r::orrecl. I agr1;;2 lo r.c11 nplv w1tl1 all requirements contained he'c1n and city ordinances and stc1te laws regulating bL11lci1ng conslruct1on I know that a permit is not valid until it bas been paid and issued.
B2100155
1/8/2021