HomeMy WebLinkAbout3400 Red Mountain Ct - Applications/Reroof - 09/08/201109/08/2011 01:47 9703539774 INDEPEDENT ROOFING I PAGE 01
City of
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
El Demolition (interior non-structural) O Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
O Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement XRoofing ❑ Sewer Line. ❑ Photo -voltaic
❑ Ventilation Cl 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 # %y Date
fi95��y Q �'
]ob Site Addr (rnquired) value of Construction (labor, materials, orofitl
Property Owner Na e . Address City/State Zip (/p Phone
0 'S215 3 1- t
Appli nt Na ddress City/State Zip Phone
Same
Contractor Lic #R294 Address City/State
,Independent Roofing Inc.. 405 22nd St.., Greeley, CO
Contractor City of Ft. Collins Sales Tax #
Sales tax number Is required by ad conbactars.
7rp Phone
80631 970-353-1389
Are you paying taxes here or by report? ❑ Here �U Report
Are you paying with your trust account? gi Yes ❑ No
Is this a residential or co project? ❑ Residential ❑ Commercial
If residential, Is It: single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office 0 Office ❑ Retail
❑ Restaurant ❑ other (explain})
Is this building So years of age or more? CI Yes VNo If yes, you may need to Contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
JYprior to 1975, you w//l need an asbestos assessment to submit with this application.
*If lawn sprinkler/backflow preventsr, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or Gty of Pt CoMns.Acense 0
Electrician Plumber Mechanical Roofer - as �- Other
I hereby acknowledge diet I have read this application and state that the above information 15 Complete and correct. I agree to
amply 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: '' T
r
Print Name: m C6LrY12�f' Signature i Date rti'