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HomeMy WebLinkAbout1032 Berwick Ct - Applications/Reroof - 09/04/2013City Of Planning, Development & Transportation Fort Collins Fort N. College Ave P.O. Box 580 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-structural) ❑ Electrical Alteration. (not service change) ❑ Gas Lighter ❑ Gas Log ❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic ❑ Ventilation ❑ 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 # 5Iao4k71 Date For office use only Sob Site Address (required) Value of Construction (labor, materials, profit) Z 6 �Aj l lf' $ Z � ,(ZL Property Owner Name ':S©- Address I �3Z�je��� cv, City/State `� 4 Q'OVU Us Co Zip Phone (�mzq 9�0 - Applicant Name Address Ci /State Zip Phone Contractor Lic # Address City/State Zip Phone c 1 1 Z Zee Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? 12� Here ❑ Report Sales tax number is required byall mntradors 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 Sl Condo/townhome (single family attached) ❑ Duplex ❑ Multifamily (apartment) ❑ Garage If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail ❑ Restaurant ❑ Other (explain) Is this building 50 years of age or more? ❑ Yes ❑ No If yes, you may need to contact Historic Preservation If this is for a demolition permit, what year was the building constructed? If prior to 1975, you will need an asbestos assessment to submit with this application. ption((ofwork ��hr-o��] P<1���-+sa:�•�6 Slti:,� Avc� :&J%An�< N{7ew *If lawn sprinkler/baclflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician. Subcontractors: List the company name or City of Ft Collins license. # Electrician Plumber Mechanical Roofer Q� 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. I ..te OflairL13 ,%,go, Z2