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HomeMy WebLinkAbout6550 Finch Ct - Applications/Reroof - 09/12/2011From Affordable Roofing'Inc 1.970.207.0289 Wed Sep 14 10:43:59 2011 MST Page 2 of 2 0tv of r _ Planning, Development & Transportation 281 N. College Ave P.O. Box 58o Fort Collins, CO 80524 Phone 970-416-2740 Fax 224-6134 OO/ER-TH&COUNTER PERMITS ONLY This application is to be used to apply for the following permfts only (check all that apply): ❑ Air Conditioning D Demolition (interior non-structural) ❑ Electrical Alteration (not service change) 0 Gas lighter ❑ Gas Log 13 Heating Unit 0 Lawn Sprinkler 13 Mobile Home replacement O Roofing O Sewer Line O Photo -voltaic j7 Ventilation © Water Heater 0 Water Line ❑ Wood/Pellet Stove (must be EPA oertifted, provide make, model and manufacturer). 1. omplete all applicable information an the application. Incomplete applications will not be accepted. Application # l l (no 7 Date C.,,�/r l �` For of a use only Sob Site Address (requlrao9 r alue of Construction (labor, materials, profit) I = Pro perty Owner Name Address City/State Zip Phone 11 ;Applicant Name Address Guy/State Zip Phone fAGLsn S czo 905,75Dom• lJt3 iz,Contractor 1jAddress A--��atilt, `�nR44 City/State T�f-i[AU4 S Zip � S�SPhone � � inn. �-t�- L+�,T�i�.,• r 020 I'":Contractor City of Ft. Collins S Tax #Are you paying tares here or by report? `�Flere Ci Report gas[axrwmber&required byarlcuvbacYor. Are you paying with your trust account? lkyes 0 No s this a residential or cgmmercial project? XResidentiai ❑ Commerdal if residential, is it Single Family Detached )I Cendo/townhome (single family attached) 13 Duplex 10 Multifamily(apartment) O'Garage If commercial, is it: O Bank ❑ Bar 0 Church ❑ Hotel/Motel ❑ Medical office 0 Office O its`ail O Restaurant ❑ Other (explain) Is this building 50 years of age or more? a Yes 3<No 3fyes, you may reed to contact HistvncPmservation If this is for a demolition permit, what year was the building constructed? rfpnor to 197S, you will need an asbwtos assessment to submit with this applicab'on. of work lawn sprinlder/bacidiow preventer, must list licensed plumber. If flrat-time A/C, must Ust licensed dedridan. Subcontractors: Usrffie company name orC.ity of cogins license ar FJectridan Plumber 'dedianica Roofer "- 15 Other I hereby arlmowledge 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 slate laws regulating building construction. I know that a permit is not valid until it has been paid and issued. IApplicant: Print fileme: Signa11,0` u ` Date