HomeMy WebLinkAbout1020 Berwick Ct - Applications/Reroof - 08/15/2013Pbnning, Development & Transportation
City C 281 N. College Ave P.O. Box 580
Fc`t GoUlns Fort Collins, CD W524 v
Phone 970-416-2740 Fax 224-6134
OVEWTHE-COUNTER PERMITS ONLY
This application is to be uaed to apply for the fdilowing permits only (check all that apply). E7 Air Conditioning
❑ Demolition (interior non-&uch#l) ❑ Electrical Alteration (not sendce charge) ❑ Gas Lighter ❑ Gas Log
El Heating Unit ❑ Lawn Sprinklir 0 Mobile Home teplacement ❑ Roofing ❑ Sewer Line. Q Photo -voltaic
❑ Ventilation ❑ Water Heater Q Water Line ❑ Wood/Pellet Stove (must be EPA wrtiRed, provide make, model and
manufacturer). t
complete all applicable inforrhd2
2tiork on
the appQcation. Incomplete applications will not be accepted.
APPlication Date
Fior olf9ce use r�n1Y: � �
Value of ConsttuCtlon (labor, materials, Profit)
F3ob SiW*d*ew (rmuwW9
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Property Owner Namp - Address CSty/Ste Zip Phone
Address city/state 2?p Phone
CordraCtor Address City/State Zip Phone I11
Contractor Oty of Ft Collins sal ax # r Are you paying taxes hWor by report? ❑'Fl"ere 0 Report
Soft taarau ps+s9 bY�/�vnfieciars Are you paying with your trust account? 11 Yes ❑ No
is this a residential or project? Ei residential ❑ Commercial
V residential, is it atingle Family peached 17 Condolt ownhome (single familY attached) ❑ Dupes
❑ Multifamlly (apartment) ❑ Garage
if commercial, Is it ❑ Bank C1 Bar O Church ❑ Hotel/Motel . ❑ I'ledleal office ❑ office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this budding 50 years of age or more? 13Yes o If yes, yvu may need to H sf&* Prasew b07
If this is for a demolition Pernik what Year was the building constructed?
Ifprior 01975, y»u MY17eed an t tb S'*Wt wBh blysapplkation.
of work
*If lawn s /baclQiow prevettter, must fist licensed PMnber• if first-time A/C. must list Geettsed eleceician.
Subeorrd actarm List Me. cumpanyfame or city of R Co#ins /!cease 4
EleKbidarL—� Flambe
Me"nlcal Rooter other
I hereby adowwledge that I have read this application and Slate that the above b►formation is complete and yea- i agree m
comply with all n-,Wirements contained herein and city ordinances add_stabe laws regulating building mnstructim- I know that a
permit is notvaod until it has bon paid and issued.
..MUM;
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