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HomeMy WebLinkAbout1251 Cape Cod Cir - Applications/Reroof - 09/09/2011From Affordable Roofing Inc 1.970.207.0289 Fri Sep 9 14:44:45 2011 MST Page 2 of 2 (i V �� Planning, Development & Transportation 281 N. College Ave P.O. Box 580 Fort Collins, CO 80524 Phone 970 4I6-2740 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 17 Demolition (interior non-structural) ❑ Electrical Alteration (not service change) O Gas Lighter 0 Gas Log P Heating Unit © Lawn Sprinkler 13 Mobile Home replacement ❑ Roofing ❑ Sewer Line 0 Photo -voltaic © Ventilation ❑ Water Heater ❑ Water Line 0Wood/Pellet Stove (must be EPA certified, provide make, model and manufacturer). Pomplete all applicable information on the application. incomplete applications will not be accepted. is Application # O I U D Date For office use only Sob Site Address (required) V lue of Construction (labor, materials, profit) 1 � CG 4 6 " ?Pro erty Owner Name Address Cdy/State Zlp Phone 70 (A c% ;Applicant Name Address CV/State Zip Phone T 5- CIOS� D Ob `Contactor Address Ctly/State T+,UbboS Zip Phone oral e R b), Th C oZ0 Contractor City of Ft. Collins S Tax ik Are you paying taxes here or by report? JVVH' ere D Report saiesrarnumaesisrequ�redDyaam�ca�.x Are you paying wig your trust account? 5kyes O No i' Is this a residential orc9mmeroal project? Residential ClCommerdal If residential, is it: .Single Family Detached ❑ Condo/townhome (single family attached) O Duplex ❑ Multifamily (apartment) O Garage If commercial, is it: ❑ Bank ❑ ear O Church 0 Hotel/Motel ❑ Medical office D Office O Retail ❑ ResMurant ❑ Other (expiaip) Is this building 50 years of age or more? ClYes No Ifyes, you mayr,eed to contact Historic Preservation If this is for a demolition permit, what year was the building constructed? 3fprior to 19n you will need an asbestos assessment to submit with tfrisapplicatfon. Description of work < V *If lawn sprinider/bac#iow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician. -Subcont mctonn List the cunpany name crGfty of Ft Collins license 3 p Electrfdan Plumbs Mechanical Roofer �— I D S� Other =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 and state laws regulating building construction. I know that a permit is not valid until it has been paid and issued. Applicant r ;, Print Name: k�!1`��� 's-: i.1/I!.!��� Signature i f''u ; ,v = i Data