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HomeMy WebLinkAbout4907 Ninebark Ct - Applications/Reroof - 08/26/201308/26/2013 11:13 3039352606 METRO PAGE 02/02 Planning, Development & Transportation City O'f 281 N. College Ave P.O. Box 580 Fort 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-structural) 13 Electrical Alteration (not service change) ❑ Gas Lighter 0 Gas Log ❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement XRoofing ❑ Sewer Line ❑ Photo -voltaic ❑ Ventilation ❑ Water Heater ❑ Water Line 17 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 # 0 u v- `� Date r office use only Is this a residential or commercial project? WResidendal ❑ Commercial If residential, is it: ❑ Single Family Detached U Condo/townhome (single family attached) ❑ Duplex 0 Multifamily (apartment) ❑ Garage If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office 0 Office ❑ Retail ❑ Restaurant © Other (explain) Is this building 50 years of age or more? ❑ Yes 0 No Ifyes, you mayneed to contacthistoricPreservation If this is for a demolition permit, what year was the building constructed? _ if prior to 1975, you ed/l need an asbestos assessment to submit mith th/s eppl/cation. ition of 0 2 *If lawn sprinkler/backftow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician. Subcontractors: IJst the company name orCW of Ft Collins license ig Electrician Plumber Mechanical Roofer 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: Name: T C Y- 4 R.6 (o 61 k Signature `r r __ Date