HomeMy WebLinkAbout1301 Blue Spruce Dr - Applications/Reroof - 05/09/2013Apr•18, 2013 3:22PM ADVANCED ROOFING
No•6022
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
❑ 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
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (musr. be EPA certified, provide make, model and
manufacturer).
Complete all applicable Information on the application. Incomplete appilcatlons will not be accepted.
Application # P 130 a l .o 3 Date 14 l 1 Y/I 3 s�Cl
For ofte use arty
yob Site Address (repuired)
Value of Construction (I bor, materials, profit)
Property Owner Name
Address City/state Zip Phone
�m
Applicant Name
Address. ��fg 14 C;iv/%tat! _ Zip P cpe
Contractor
Add city/state Zip Phase
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report? ❑ Here ❑ Report
salestaxnumber srequLedbya#conbact=
eVff
Are you paying with your trust account? gq�es ❑ No
Is this a residential or commercial project? O Residential AC,ommercial
If residential, is It: ❑ Single Family Detached ❑ Condo/tgwnhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office `1kOffice ❑ Retail
❑ Restaurant ❑ other (explain)
Is this building 50 years of age or more? D Yes T3kNo If yes, you may need to contact MnWnc Preservation
If this Is for a demolition permit, what year was the building constructed?
If prior to 1975, you will need an asbestW assessment to subunit with bWs app✓icabon.
Description of work
*If lawn Sprinkler/backlF& preventer, must list licensed plumber- If first-time A/C, must list licensed electricia
Subcontractors: List Me company name or City of Ft Collins license � C � Ot 55
�
EkEirldan Plumber Mechanol i _ Rool Other
I hereby acknowledge that I have read this application and state that the above information is co/hplew and correct. I agree to �
c0mPIY with all requirements contained herein and city ordinances and state laws regulating !wilding construction. that a
permit is not valid until It has been paid and issued.7
Applicant; ��jj
Print Name: AMA / / I GL(,� I/1 5 Signature pate
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