HomeMy WebLinkAbout2520 Cedarwood Dr - Applications/Reroof - 06/21/2013City of Planning, Development & Transportation
281 N. College Ave P.O. Box s8o
,,., art Collins Fort Collins, CO 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--structuraD ❑ Electrical Alteration (not service change) ❑ Gas Lighter El Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ad Roofing ❑ Sewer Line ❑ Photo -voltaic
O Ventilation q Water Heater ❑ Water Line ❑ 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 #1�13 o -2�>00 `7 Date 'r o f �3
For of ue use only
Is this a residential or commercial project? ® Residential ❑ Commercial
If residential, is it: ® Single Family Detached ❑ Condo/townhome (single family attar ❑ Duplex
❑ Multifamily (aparbnent) ❑ Garage
If commercial, Is it. ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motes ❑ Medical office ❑ Office ❑ Retall
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes D No If yes, you maynEedto cant wtH&oricPres--rv,7 Fo,;
If this is for a demolition permit, what year was the building constructed?
Ifpnor to 1975, you W11 nod an asiestos assent to submitWth by/s app/icat5on.
Description of work
U Q
*If lawn sprinkler/baddiow preventer, must list licensed plumber. If first-time A/C, must list licensed elKtrioan.
Subcontractors, List the axnpany name or City off•? Collins lACEnX #
Elecbidan Plumber Mechanical Roofer f j J ,C `� other
I hereby acimowiedge 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 fawn regulating building constnMion. I know that a
permit is not valid until it has been paid and issued,
Applicant: �%t5b
Print Naine: i� t;si- - 7&71 Signature" — Z pate aie�p f