Loading...
HomeMy WebLinkAbout1906 Ames Ct - Applications/Reroof - 04/03/2013A-r.03.2013 12:33 PM PAGE. 2/ CRY of Planning, Development & Transportation 281 N. College Ave P.O. Box $80 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 L] 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 #^) 0014 sot , Date Am- 3 , 7013 y "3 For office use only lob Site Address (required) Value ofinstruction (labor, materials, profit) oao n 10 00 Property Owner Name Address City/State Zip phone t (o zip a Applicant Name Address City/State Zip Phone Contractor Address City/State Zip Phone ZI7A C o Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? j81 Here ❑ Report sal bxnumberis. epu;,ed6Ya//wn&aaws Are you paying with your trust account? 09 Yes 0 No pulds tk R- Is this a residential or commercial project? it Residential C] Commercial If residential, is it: iW Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex C] Multifamily (apartment) ❑ Garage If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail ❑ Restaurant ❑ Other (explain) Is this building Sa years of age or more? ❑ Yes )W NO If yes, you may need to ConloCt H&for/c Preservat/on If this is for a demolition permit, what year was the building constructed? tfpr or to 1975, you w/ll need an asbestos assessment to submit with this application. Description of work *If lawn sprinkler/backfiow preventer,. must list licensed plumber. If first-time A/C, must list licensed electrician. Subcontractors: List the company name or CV of Ft Collins license Becuidan Plumber Mechanical 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: Print Name:/i'��'A (SLklZCZ"J!!?= Signature