HomeMy WebLinkAbout1404 E Pitkin St - Applications/Reroof - 12/16/2013From Affordable Roofing Inc 1.970.207.0289 Fri Dec 13 13:51:41 2013 MST Page 2 of 2
Citty oT__
planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970.416 2740 Fax 2246134
OVER THE -COUNTER Por."n"I'M TO Sw ONLY
This application is to be used to apply for the following permits only (check all that apply). ❑ Air Conditioning
❑ Demolition (interior nonstructural) 0 Electrical Alteration (not service change) ❑'Gas Lighter 4 Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement )4 Roofing d Sewer Line ❑ Photo -voltaic
Q Ventilation Q Water Heater 0 Water Line 0 Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete ail applicable information on the application. incomplete application/s will not be accepted.
Application # Date r Z`/ G ��
Fpioffice use only ,
Job Site Address (raqulredJ
Valuej9f Construction (labor, materials; profit)
I 0
�` 5 OLD.
Property Owner Name Address
City/State Zip
Phone
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Applicant Name Address
City/State Zip
Phone q -70 -
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20-2"Co o
ContractoS Address
"ty/State Zip
Phone
Contractor City of FL Collins Sales Tax
Are you paying taxes here or by report? 16Mere
0 Report
sales taxnimber&requiredbya#canttmrms
Are you paying with your trust account? F(Yes
❑No
is this a residential or commercial project? gResideatial {3 Commercial
if residential, is It: Id Single. Family Detached 0 Condo/townhome (single family attached) ❑ Duplex
O Multifamily (apartment) ❑ Garage
If commerdal, is it: ❑ Sank ❑ Bar ❑Church 0 Hotel/Motel ❑ Medical office ❑.Office ❑ Retail
R Restaurant ❑ other (explain).
Is this building SU years of age or more? ❑ Yes ❑ No If yes, you may need to contact frrstoric Preservation
for demolition permit, what year was thd*building constructed?-
If this is a
IFpdor to.1975, you will need an asbestos assessment to submit with this AWk3fron.
w in
Descil ion ofwork a �J
352 V-
*If lawn'sprinklerJbackflow preventer, must 1154- licensed plumber. If first-time AJC, must list licensed elettrldan_
subcontractors. Lb7 the cvrrrQany acme or City oiFt Cd/ITRs license A
9eCtr+dsrlPiwnber. Mechanira! Roofer R` u Jr9 Other
.— .. _
I hereby admowiedge that I have read this application and state that the above information is complete and correct I agree to
contained herein and city ordinances and state laws regulating building construction. I know that a
comply wRh all requirements
permit is not valid until It has been paid and issued.
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