HomeMy WebLinkAbout2100 Thunderstone Ct - Applications/Reroof - 02/01/2013Feb 01 13 10:45a
1-970-669-5999 PA
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City
33 ID /V, e� r h e C ��� �//4 Planning, Development &Transportation
&Of ,� a v 1 Gc h cJ C0 . 281 N. College Ave P.O. Box 580
t Collin YP'05 3-7 Fort Collins, CO 80524
tea- Phone 970-416-2740 Fax 224-6134
OVER-THE-COUNTER PERM17S 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 sere change) 0 Gas Lighter 0 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 # b� LK date 7-1
For ofte use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
ro o -i hur�d�r�foh�
�'7500 `�
Property Owner Name Address
City/State Zip PhoneQ�B)
e3q�6�1 Pie h to a/oo FCC. Fa5a5 51y-96a
Applicant Name Address
City/State Zip Phone
A- -Sh;. RooL 30 A%.o4iP7
ca/Y, '"lio 0Ve1,inc2 D eos3
Contractor Address
City/State Zip Phone
3. Shar00T3h
97v-&6-e_-&999
Contractor City of Ft. Collins Sales Tax # q 10 3 6
Are you paying taxes here or by report? ❑ Here $,Report
Sales Lax number tsrequiredbya/lmrrbac>brs.
Are you paying with your trust account? ' Yes ❑ No
Is this a residential or commercial protect? aResidential ❑ Commercial
If residential, Is it: ;® Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ multifamily (apartment) ❑ Garage
If commercial, is it: O Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office p Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? a Yes ❑ No If yes, you may need to contactH/stork PreselvaVon
If this is for a demolition permit, what year was the building constructed?
Ifprror to 19Z5 you will need an asbestos assessment tP submit with this app&aboa
- u lawn spnnaer/Dacxnow preventer, must lid licensed plumber. If first-time A/C, must list ricensed electrician.
Subcontractors: List thecompany nameorCriyofFtColGns/rcense# R 15 99
Bectriden Plumber Mechanical Roofer _ �C 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 ws regulating building construction. I know that a
permit is not valid until it has been paid and issued.
Applicant:/J� ��
Print Name: 24 �'i�4�� � � Signature
71 Date