HomeMy WebLinkAbout424 S LOOMIS AVE - PERMITS - 2/18/2021Owner:ENGELMAN ALEXIS IRREVOCABLE 2003 TRUST
14730 SUTTON ST
SHERMAN OAKS,CA 91403-4143 Phone:970-443-0950
Zoning:Front setback:Rear setback:Right setback:Left setback:
Minor Amend #:Plat File #:ZBA Case #:
Zoning district:NCM -NEIGHBORHOOD CONSERVATION -MEDIUM DENSITY 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:BALANCE POINT HEATING &A/C
5854 LOCKHEED AVE
LOVELAND,CO 80538
License #:H-2064
Phone:970-484-4440
Supervisor cert #:
Subcontractor(s)Phone License Number
Mechanical:BALANCE POINT HEATING &A/970-484-4440 H-2064
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 02/19/21:$203.34 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 #:B2101343
Issued Full:02/19/2021
Permit Type:Residential Mechanical
Site Address:424 S LOOMIS AVE
Job Valuation:$5,950.00 Category:Residential
Signature:Print Name:Date:
Form Revised Oct 2010
Transactions
Method Check Number Date Paid Amount Paid Comments
Trust Account 02/19/2021 $203.34
Receipt issued:02/19/2021 Total Paid to Date:$203.34
Fee Description Account Code Fee Amount Amount Paid Date Paid Amount Due
City Sales/Use Tax 251.122030 $114.54 $114.54 02/19/2021 $0.00
County Sales/Use Tax 100.217030 $23.80 $23.80 02/19/2021 $0.00
Permit Flat Fee -$65 1000.422010 $65.00 $65.00 02/19/2021 $0.00
TOTAL FEES:$203.34 $203.34 $0.00
TOTAL BALANCE DUE AS OF 02/19/2021:$0.00
Community Development &Neighborhood Services
281 N.College Ave Fort Collins,CO 80522
970.221.6760 970.224.6134 -fax
Building Permit #:B2101343
Issued Full:02/19/2021
Permit Type:Residential Mechanical
Site Address:424 S LOOMIS AVE
Job Valuation:$5,950.00 Category:Residential
Fee Amounts are valid for date of this document only.Fees subject to change without notice.
Form Revised Oct 2010
Application # _____________________________
Date Received ___________________________
WATER HEATER & HVAC PERMIT
APPLICATION
ALL information is REQUIRED. Incomplete applications will not be accepted.
Job Site Address
Address ________________________________________________________________ City/State/Zip _________________________
Property Owner Information
Name ______________________________________________________Phone Number _____________________________________
Address ________________________________________________________________ City/State/Zip _________________________
Scope of Work
Air Conditioner
Furnace
Minisplit
Boiler
Water Heater
Other ___________________
Contractor Information
Name ________________________________________________________________________________________________________
Company ______________________________________________________________
License Holder ____________________________________ License Number ______________________________________
Electrical Contractor Information (only required for new installs)
Name ________________________________________________________________________________________________________
Company _________________________________________________ License Number ME- _____________________________
COMMERCIAL ONLY
Rooftop Yes No Note For new rooftop equipment or replacements that are heavier than original, engineered documentation
needs to be provided to show roof can support equipment.
Equipment is same weight or lighter Yes No Equipment is same footprint or smaller Yes No
Equipment is in same location Yes No Equipment is same height or smaller Yes No
Location ______________________________________
If for a water heater or boiler in any food or beverage serving facility/Day Care/Institution occupancies, I have approval from the
Larimer County Health Department for minimum water heater capacity. Yes No
Tenant Name ____________________________________________________________
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.
Print Name Signature Date
Community Development and Neighborhood Services
281 N College
Fort Collins, CO 80524
buildingservices@fcgov.com
970-416-2740
Description Valuation
(per appliance)
New or
Replacement?
1.
2.
3.
4.
5.
6.
7.
424 South Loomis Fort Collins, CO 80521
Sarah Engelman 970-443-0950
424 South Loomis Fort Collins, CO 80521
Tankless water heater $5950.00 replace
$5950.00 replace
Karen Arnold
Balance Point Heating & Air Conditioning
William Kusmik H-2046
Karen Arnold 02/19/2021
Lennox furnace 70,000 BTUH
B2101343
2/19/2021