HomeMy WebLinkAbout7215 Trout St - Applications/Reroof - 08/04/2011From Affordable Roofing Inc 1.970.207.0289 Thu Aug 4 08:43:15 2011 MST Page 1 of 1
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
Is. application is to be used to apply for the following permits only (check all that apply). ❑ Air Conditioning
Demolition (interior non-structural) 0 Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
Heating Unit ❑ Lawn Sprinkler O Mobile Home replacement ❑ Roofing C7 Sewer Line ❑ Photo -voltaic
Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
alIIapplicable information on the application. Incomplete applications will not be accepted.
# B.1 I4 oZ Date '
For 0070s use on �-
Sob Site Address (required) Value of Construction (labor, materials, profit)
06
'Prooertv Owner Name Address City/State Zip Phone
Name
Address
Gty/State Zip
Phone
S
60
Address
City/to Zip
Phone
r
- rrX,,
r City of Ft Collins Sales Tax
Are you paying taxes here or by report?
trust account?
ere ❑Report
❑ No
imberisre4+dred Byallmntractmx
Are you paying with your
Is this a residential orcommercial project? residential ❑ Commercial❑Duplex
If residential, is it: Ingle Family Detached. ❑ Cando/townhome (single family attached)
❑ Multifamily (apartment) D Garage
urch ❑ Hotel/Motel ❑ Medical office 0 Office 0 Retell
If commercial, is it: ❑Bank ❑Bar ❑Ch
❑ Restaurant ❑ Other (explain)
Is this building so years of age or more? O Yes `�Qwp�o If yes, you may need to contact Historic Preservation
:.Lf this is for a demolition permit, what year was the*buliding constructed?
an asbestos assessment to submit with MIS appliotion
If pl7or to 1975, you will need.
Description
r
*If lawn sprinkler/badfflow venter. must list l d plumber. If first-time AJC, must list licensed electrician.
Subcontractors: List the company name or Gty of R Collins firense f
Elecvidan`— Plumber
Mechanlcal Roofer , t R Sr
—
I hereby acknowledge 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 an' state laws regulating building construction. I know dud a
;permit is not valid until it has been paid and Issued. ;
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IIWnt: 1' I Date
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