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Home My WebLink About2919 SOMBRERO LN - PERMITS - 6/2/2021City of ktColli~ Site Address: 2919 SOMBRERO LN Job Valuation: $5,195.00 Category: Residential Owner: BEDNAR RACHEL M 2919 SOMBRERO LN Community Development & Neighborhood S e rvices 281 N. College Ave Fort Collins, CO 80522 970.221.6760 970.224.6134 -fax Building Permit#: 82104259 Issued Full: 06/02/2021 Permit Type: Residential Mechanical FORT COLLINS , CO 80525-2461 Phone: 630-669-9848 Zoning: Front setback Rear setback: Right setback Left setback: -----Minor Amend #: ______ Plat File #: ZBA Case#: Zoning district RL -LOW DENSITY RESIDENTIAL DISTRICT Legal: Subdivision/PUD: Filing#: ----------------Lot#: Block#: -------- Code: Res sq ft: ____ Com sq ft: # of stories: ____ 0cc Group: Fire Sprklr: ____ Stock plan #: ___ _ Contractor: REDSTONE HEATING CONTRACTORS, INC. PO Box 336 Be llvue, CO 80512 Subcontractor(s) Mechanical REDSTONE HEATING CONTRACTO Work Description: Replace ing existi ng A/C unit w ith new. Ind sq ft: ______ Basement sq ft: _______ _ Const Type -,---------------------Stock plan options: ------------------ License #: H-3699(C) Supervisor cert#: Phone 970-217-5658 Phone 970-217 -5658 Lic ense Number H-3699(C) 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/mobi le Possible Inspections Required: 204 302 3 0 0 301 TOTAL FEES PAID AS OF 06/02/21: $185.78 ** Fee Detail Displayed on Next Page Payment m ethod: Check 2771 As a condition for the issuance of a pe rmit, I hereby declare that I am the owner or owner's agent, auth orized to perform th e proposed work on the property described herein. I agree to comply with all the requireme nts contained herein, and City ordinances. and State laws associated with such wo rk. 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 , aba ndoned or not inspected within 180 days from the date of such permit. Carbon Monoxide Alarm required within 15 feet of each bedroom entrance. Signature: Print Name: Date: ------------------------------------- Form Revised Oct 201 0 City of ,k!:tColli~ Site Address: 2919 SOMBRERO LN Community Development & Neighborhood Services 281 N. College Ave Fort Collins, CO 80522 970.221.6760 970.224.6134 -fax Building Permit#: B2104259 Issued Full: 06/02/2021 Permit Type: Residential Mechanical Job Valuation: $5,195.00 Category: Residential Transactions Method Chet;k Ny!!Jb~r Date Paid Check CK#2771 06/02/2021 Receipt issued: 06/02/2021 Total Paid to Date: Fee Descri~tion Account Code City Sales/Use Tax 251 .122030 County Sales/Use Tax 100.217030 Permit Flat Fee -$65 1000.422010 TOTAL FEES: Amount Paid Comment~ $185 .78 $185.78 Fee Amount Amount Paid Date Paid $100.00 $100.00 06/02/2021 $20.78 $20.78 06/02/2021 $65.00 $65.00 06/02/2021 $185.78 $185.78 TOT AL BALANCE DUE AS OF 06/02/2021 : Amount Due $0 .00 $0.00 $0.00 $0.00 $0.00 Fee Amounts are valid for date of this document only. Fees subject to change without notice. Form Revised Oct 2010 Cityof ktColli~ 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). □ 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 # __________ _ For office use only Date _C_-_l -----'-1,--'--\ ______ _ Job Site Address (required) 1-q \ I\ .S "" I' n :, L", Value of Construction (labor, materials, profit) j -l t-\J-~ Property Owner Name Address City/State Zip Phone ~ L", ~\ \\, f" c_ (")I.), till\ l\-t.\ZS""l3 Applicant Name :S '-\J ,,_J\r. Address City/State Zip Phone ~1-0,'L\7. Address (_" ~r~~~l"'..- Sales Tax# Safes tax number is required by all contractors. t..{ .r n.. "),. Are you paying taxes here or by report? □ Here Are you paying with your trust account? □ Yes Is this a residential or commercial project? ~esidential D Commercial If residential, is it: ~Single Family Detached D Condo/townhome (single family attached) D Duplex D Multifamily (apartment) D Garage If commercial, is it: D Bank D Bar D Church D Hotel/Motel D Medical office D Office D Retail D Restaurant D Other (explain) ________________ _ Phone 0\1-u ,'.t.0--~ i-~ ~ Report I!:} No Is this building 50 years of age or more? □ Yes @ No If yes, you may need to contact Historic PreseNation If this is for a demolition permit, what year was the building constructed? ______________ _ If prior to 1975, you will need an asbestos assessment to submit with this application. *If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time NC, must list licensed electrician. Subcontractors: List the company name or City of Ft Collins license # Electrician ______ Plumber ______ Mechanical \J..-)\ t\ ~ 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: __ • f A \ l Print Name: ~.,.. .\ "'"' V "'--r::. /\ \.,,