HomeMy WebLinkAbout2906 Tumbleweed Ln - Applications/Reroof - 06/04/2013Jun 05 2013 10:34RM HP LRSERJET FAX
1970-267-9005 P.1
City cyf
ort Collins
Planning, Development&Transportation
281 N. College Ave P.O.:Box 580 .
Fort Collins, CO 80524 Q
Phone970-416-2740 Fax-224-6134
OVER-THE-COUNTER PERMITS ONLY /' TV
This application is to be used to apply for the following permits only (check all that apply). O Air Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not se ice change} ❑Gas Lighter ❑Gas Log
❑ Healing Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement Roofing ❑ Sewer Line ❑ Photo -voltaic
El Ventilation ❑ Water Heater ❑ Water Line ElWood/Pellet Stov (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable information on the application. Incomplete app11 do will not be accepted.
Application #�� M7 Date
For o/ftte use only
lob Site Address (required)
Value of Co
ctlon (labor, materials, profit)
2
Property er Name Address
City/State
Zip
Phone
Applicant Name Address
City/State
Zip
Phone
Po Box 1326
Ft. Collins
80522
9705661884
Co dor Address
City/State
Zip
Phone
Ticos Roofing Inc Po Box 1326
Ft. Collins
80522
9705661884
Contractor City of R. Collins Sales Tax #
Are you paying taxes here or by report?
IZ Here ❑ Report
Saks tax number isregaftdbyall o»tracrors
Are you paying with your trust account?
❑ Yes ❑ No
R-1686
Is this a residential or commercial project? IN Residential ❑ Commercial
If residential, is k: m Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
Ifcommerclal, is It: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes ❑ No Ifyes, you mayneed to mntactHistorkPreservation
If this Is for a demolition permit, what year was the building construed?
If prior to 1975, you will need an asbestos assessment to submit with this application.
Description of work Tear off to decking & replace w/ asphalt shingles provide required vents _
*If lawn WrInkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician,
Subcontractors: L& the company name or Oty of Ft Collins license #
Plumber Mechanical Roofer R-1686 Other
I hereby acknowledge that I have read this application
comply with all requirements contained herein and city
permit is notvalWuntil R has been paid and I-%
Applicant
Print Nam
that the above information is complete and correct I agree to
s and state laws regulating building construction. I know that a
00