HomeMy WebLinkAbout2248 Silver Oaks Dr - Applications/Reroof - 08/23/2011From Affordable Roofing Inc 1.970.207.0289 Wed Aug 24 08:12:39 2011 MST Page 1 of 1
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fart 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).13 Air Conditioning
0 Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
0 Heating Unit ❑ Lawn Sprinkler Q Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo-voitaic
a 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 # � � � �� Date
Foroffice use only `, •5 8 I
Site Address (A
Site
r • Value of ConstTciion (labor, materials, profit)
'
�JI
erty Owner Name I(J Ai
Address City/State
Zip
Phone
Iicant Name
Address City/State
.
Zip
Phone
[ w VL[
�cta,
tra
Address Ct /State
Zip
Phone
ractor City of Ft. Collins Salei3.T
jaxnumberis &Vuked by all mnbaCWm
Are you paying ta&es here or by report?ere O Report .
Are you paying with your trust account? es O No
:cis this a residential or commercial project?Residential ❑Commercial
!If residential, is it: gle Family Detached 0 Condo/townhome (single family attached) 0 Duplex
O *Mu ItiFamily (apaament) 0 Garage
If commercial, is it ❑ Bank O Bar O Church ❑ Hotei/Motel 0 Medical office ❑Office ❑Retail
❑ Restaurant ❑ Other (explain)
.' 0 Yes If yes, imu may
Is this building 50 years of age or more? need to Contact y�storic Preservation
If this is for a demolition permit, what year was the building constructed?
If prior to 1975, yrw w!/l need an asbestos assessment to submit with Vs apptkation.
of work
lawn sprinliler/baddlow
`.Subcon racWw. List the CWW3ny name or Uty of R CoN/ns Lic>°nse #
Other
Elearidah _ Plumber
MechanicalRoofer -
must list licensed plumber. If first-time A/C, must list licensed electrician.
?,I hereby acknowledge that I have read this application and state that the above information is complete ana mrrecr. i agrrx w
comply wlth all requirements contained herein and city ordinances aM state laws regulating building construction. I know that a
;.permit is not valid until It has been paid and issued. 1
,t
Applicant::rL �r��J j
:'.DAM. Mama' .f�'i'1'l.L( �i1n,t� �"(h�? Signature /1 " 1 ��%� � `— - i�ate� / .