HomeMy WebLinkAbout2400 Sunstone Dr - Applications/Reroof - 08/08/2011Planning, Development & Transportation
�rrC111}� 281 N. College Ave P.O. Box 58o
Eollins :Fort Collins, CID 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 ON Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line O 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 # F 110 9 A f Date
For obice use only
lob Site Address (requlred)
Value of Construction (labor, materials, profit)
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Property Owner Name'
Address
City/State Zip
Phone
Applicant Name
Address
City/State Zip
Phone
Contractor
Address
City/State Zip
Phone
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Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
® Here ❑ Report
Sale; tax numberirrcg 1mdbyairmncar&vs.
45 839
Are you paying with your trust account?
® Yes ❑ No
Is this a residential or commercial project? ® Residential ❑ Commercial
If residential, Is It: ® Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar El Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? O Yes ®No Ifyies, yvu mayneed to contact HistoncFIrwervatlon
If this Is for a demolition permit what year was the building constructed?
ifpnor to 1975, yr?t! will need an asbestos amessnrent to submit with this application.
Description of work REMCvE 40(N t.6s tg Cl&cic N ty 3C?;I?, NRt:L Phi; ht>,:WLe
3 QugstE�S
*If lawn sprinlder/bacidiow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractm: List the company name or ply of Ft Coffins ffcetme # AA
Eiecirldar Plumber Mechanical RooferOther
I hereby acknowledge that I have read this application and state that the a6dve Information is complete and correct. I agree to
comply with all requirements contained herein and city ordinances and state laws regulating building construction. I loww that a
permit is not valid until It has been paid and issued.
Applicant: 1 F ,
Print Name: �6bQ i`t l�7_ `'l3hQC Signature Date
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