HomeMy WebLinkAbout1345 Forrestal Dr - Applications/Reroof - 06/04/2013Jun, 4. 2013 9:20AM Bob Behrends Roofing
No•3024 P- 2
city of pla;lniatg, Dayegoprner3t &7rer,;pc�r.tatio��
281 N. College Ave P.O. Box 580
�� Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
OVEIR- HEWCOUN 1 ER PERMITS ONLY
This application is to be used'to apply for the following permits only (check all that apply), p Air Conditioning
❑ Demolition (interior non-strLeturai) O Electrical Alteration (not service change) Q Gas Lighter O Gas Log
O Heating Unit Q Lawn Sprwer ❑ Mobile Home replacement X Roofing Q Sewer Line Cl Photo -voltaic
O Ventilation ❑ Water Heater 0 Water Line Q Wood/Pellet Stove (must be EPA
manufacturer), certified, provide make, model and
Complete all applicable infomiatien On the application. Incomplete applications will not be accepted.
Application .# C).'� %�% Date
ForCINce use mi
Job Silte Address (requirad) Value of Construction {labor, materials, -profit)
Property Owner Name Address City/State
P Phone
�.... �. �Y ..N,..
Applicant ame Address
\ City/State Zip Phone
Contractor
Lic # 2 p�dress City/State Tip Phone
Contractor City of Ft. co)IjinA sibsTax # Are you paying taxes here r by report? Here ❑Report
Sa/es[axnumb '3 bYa#corpacm� Are you in with our trust account?
Y paying Y es . q No
Is this a residential or comrnerEa{project? --�Nesldentiai ❑ Commercial
If residential, is it:. ingle:Pamily Detached ❑ Condo/townhome (singfe family attached) 11 Duplex
0 M'Wai* (apartment) CI Garage
If commercial, is -it: p Bank 1E Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ OFfce p Retail -
t ❑ Other (explain)
Is this building 50 years of ageor more? n yll �O If yes, you may need to Contact Hlato6c Preservation
If this is for a demolition laerxit, what year was the building constructed?
If prior to 1975, you w//IneW asasl7p_st05 assessment en submit with this applicapon.
Description of work
*If lawn sprinkler/badcflow prevectgr, must list licensed plumber. IF first-time A/C, must list licensed
Subcontractors; 113C t%7e comFMgname or pry ofFtCo1,r2ns 11cense #
Electrician
^
Mechardcal Roofer � Other.
I hereby acknowledge that I ,-aye,,ad this appiicadon and Rate that the above information is complete. and correct, 1 agree to
comply with M requirements toriffned herein and city ordinances and state laws regulating building constructfan. I :cncuv that a
Permit is net valid until it has;een paid and issued. .
Applicant;
P;nt.Marrm,e:�� c�.;�5 Signature �