HomeMy WebLinkAbout2005 Spring Ct - Applications/Reroof - 09/26/2012Seo.26. 2012 11:57AM ADVANCED ROOFING
No•5194 P- 1
Fort 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). ❑ Air Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not se ce change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement KRoofing ❑ 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,
jo
Application # B 1 �05 1S 1
For ottice use only
�G
Date 9 /,Y=e
lob Site Address (required) Value of Construction (labor, materials, profit)
.- S <?Oa
Property Owner Name Address City/State Zip Phone
IF
Applicant Nanig Address City/state Zip Phone (66"
Contractor Addrl&s City/State Zip Phone
Gv4 �MvyA_
Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? ❑ Here ❑ Report
lvakv Wx Inimber = b Omntracmns. Are you paying with your trust account? des ❑ No
Is this a residential or commercial project? '�.$tsidential ❑ Commercial
If residential, is it: 11 Single Family Detached ❑ Condo/townhome (single family attached) Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office Q Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? 0 Yes ❑ No If)es, you mayneed to contact Hlstolk preservation
If this is for a demolition permit, what year was the building constructed?
Yprlor to t975, you will n4mdan as[>anlos a_zwment to submit wibh bbis appllta&on.
Of
Tufzz�07
*If lawn sprinkler/badkflow preventer, must list licensed plumber. If first-tlme A/C, must list licensed electrician,
Subcontractors: UstbHecompany name or01yormCollins llcenS'e#
Electrician Plumber Mechanical Roofer l if'i 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.
Prriint Name:,)JY_�/ (1 //>'iis Signature �� Date