HomeMy WebLinkAbout2432 Rock Creek Dr - Applications/Reroof - 11/09/2012From Affordable Roofing Inc 1.970.207.0289 Thu Nov 8 14:53:55 2012 MST Page 2 of 2
CttyOf Planning, Development & Transportation
r�.;...e• 281 N. College Ave P.O. Box. S80
F E �` �.f i l .,.,.,,; f.•::.I y} Fort Collin
Q � R '"� `� s• E; Q1. -E -, U! Phone 970416 27C44 Fax 224-6134
OVER-THE-COUNTER PERMITS ONLY
This application is to be used to apply for the foliowing permits only (check all that apply). O Air Conditioning
O Demolition (interior ran-structurai) ❑ Electrical Alteration (not service change) O Gas Lighter n Gas log
0 Heating Unit ❑ Lawn Sprinkler 0 Mobile Hoare replacement ❑ Roofing ❑ Sewer Line 'D Photo-vultarc
1-2 ventilation 0 Water Heater O Water Line Ci Wood/PeUet Stove (must he EPA CPdified, provide maka. model and
manufacturer).
Complete all applicable information on the application. incomplete applications will not be accepted.
Application # 3 4 to Date
Fpr arh're use o.7ty
Sob Site Address rrMuDed)
Value of Construction (tabx, materials, pmlit)
r? 4 '3,2 TLeick <"-C ee -
'
Property Owrrer Name Address
'C"Istate Yip Phone
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Applicant Name Address
City,15Wte ZIp Phone -i-?d
FikF» a:i'. 'Z'06-(Ant
Contractor Address
-� oty/State Zip Phone
Cnrrfracttx Oty of Ft. Collins Sales Tax d
Are you paying Ube$ here or by report? ❑ Here L] Report
SALN G1.Ambe'-sfrwaeJDy 0elwwacb11.
Are.. you paying wrm your trust account? O Yes i7 No
Is this a residenflal or commercial InojeCt? 10 Resirkntiaf p Cilmrrardat
If residential, is it: 0 Single Fancily Detached ❑ Condoltownho!ne (single family attached) ❑ Duplex
E3 Ptjiti£amAy, (apatbfent) ❑ Garage
If Commercial, is it: 0 Hank ❑ Bar ❑ Churrh ❑ Hotd/Motel O Meciml office: ❑ office 13 Retail
❑ Restaurant 0 Otfter (explalh)
Is this buildng 50 years of ago or more? ❑ Yes ❑ No bf yes, )cc, may need to contact Hmft rc Rzsevabow
If thm is for a demolition permit what year was the building cwrstructed?..... ____ ...... ------------------ ---------
IPprrotrn197ZYMWWI flMd n.15&'afneasscSA'.•. ttoSutvrr&With tfr ar3y`r'cabM .
Descriptr of work
•If lam sprinkksluackflCw preventer, must Itst licensed ptumbet. If first -tune MG must flat ticensed efeMcfan.
Subcontractors: L& the ctanwny want a dry Of Ft Cn0n fias 0
8ecFtd3n..----_ Plumber W-dnarocaf--------_----,---- fipefer Other
1 hereby actrtowteege that 1 have :read tMs apptitaticn aid statetnat fie above tnfdrmatton 1, uxnptete and wrnct t agree to
Wrnply with all requirements contained herein and city m4mances and state laws requla l ng building construction. i.know that a
permit is not valid rmtb It has beat paid and onxd.
;r:r,•1�,,: __ Date lid
Pont Nana: � ., ._,_, �s.::...._— rely:_'-,,rx:..------...---......
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