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Home My WebLink About4519 Viola St - Applications/Reroof - 11/12/201311/12/2013 13:50 9704612547- ATLAS PAGE 01/01 C`ctC d-tins Ile Planning, Developmem 8E'IM porralon 281 Ni College Ave P.O. Box 580 Fort Collins, oo 80524 Phone 9.70-416-2740 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). 0 Air Conditioning 0 Demolition (Interior non-structural) 0 Electrical Alteration (not sB change) 0 Gas Lighter 0 Gas Log ❑ Heating Unit 0 Lawn Sprinlder 0 Mobile Home replacement Poofing ❑ Sewer Line 0 Photo -voltaic ❑ Ventilation ❑ Water Heater ❑ Water tine 0 Wood/Pellet Stove (must be EPA certfied, provide make, model and manufacturer). Complete all applicable Information on the application. Incomplete applications will nothe accepted. y� _ .. - l Application #� 13 Date r%v oflir use only Job Skte Address (tWuW Value of Consbuctlon (labor, mataarials, per) 14 Property Owner Name Addrms 0EY/State Zip P � 7 S13 Applicant Name Address O&M Zip Phone COr1tTaCtOr Address city/state zi rle 77 Rc" ck-154 SOP Cont -actor City of Ft Collins Tax # 11 10-5t Are you paying taxes here or by report? p tLere Report saes tar nwnbersregoQdbyadravvatwx Are you paying with your trust account? Mhs 0 No Is this a residential orring16 ercial protect? L l Residential 13 Commercial if residential,. Is it: Family Detached 13Condo/townhome (single family attached) 13Dupkc famlly (apartment) [3 Garage If commercial, is it: O bank ❑ Bar 0 0urch D Hotel/Motel ©INedtcal of% 0 Office CI III 13 Ptestaurant © Other (explain) Is this Wilding 50 years 4f age or morel ©Yes ❑ No. IfyE4 jw may fmwd fu conbxtH& rsePf EWrKdia7 If this Is for a demolition permit; what year was tiie bulldtlig constructed? If prior fo 1Y75, you w111 need an aMess assEmTi nt to wbrn t MM Mis apphtaffon. Description of work Q -,1, .� *If lawn 5pflnlder/bacdldw pmventer, must list lkased plumber. If first- irm NC, must list licensed electridan. sui>wtantsaemrs: tfsc file any name ar cZiy ofR CaUir>zslkairse , Eleclrrpan Plumber Medtenirdr Roofer Otflf:r I hereby acluvMedge brat I have read this appllmtlon and state that the above infipt swan is complete and oq TaZ I- agree W comply with all requirements contained heron and City or dinanGes and stye laws regulating buildingconsb%xilon. I know tint a pennit is not valid until it has been paid and Wsao.