HomeMy WebLinkAbout6505 Solar Ct - Applications/Reroof - 09/30/2011City f Planning, Development & Transportation
F6ty O281 N. College Ave P.O. Box 580
rt Collins Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-61-34
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
❑ Demolition (interior non-structural) Q Electrical Alteration (not service change) ❑ Gas Lighter. 0 Gas Log
Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacementRoofing ❑Sewer Line Photo -voltaic
• Ventilation 0 Water Heater ❑ Water Line 0 Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).- CJC
Complete all applicable informat'on on the application. Incomplete applications will not be accepted. U
Application #
For of b use only
3ab Site Address (require(fValue.of instruction (labor, materials, profit)
Property Owner Name Address City/State Zip
Phone
Applicant Name Address
City/State Zip
Phone
Contractor Lic # Address
City/State Zap '
Phone
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report? Here
❑ Report
Sales tax number arequiredbyaficonftcWm
Are you paying with your trust account? 0 Yes
,'R�No.
Is this a residential or commercial project? X Residential ❑ Commercial
If residential, is it ;0Single Family.Detached ❑ Condo/townhome (single family attached) 0 Duplex
0 Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank 17 Bar ❑ Church ❑ Hotel/Motel D Medical office ❑-Office ❑ Retail
0 Restaurant 0 Other (explain)
Is this building 50 years of age or more? 0 Yes XNo If yes, you may need to contact Hisfnric Pres&vadon
If this is for a demolition permit, what year was the building constructed? Tom'
Ifpdor to 1975, you will need an asbestos assessment to submit wi6h ffiis application.
Description of
*If lawn sprinkler/backfiow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List ffie company name or City of Ft Collins Arense
Seetrician - Plumber Mechanical Roofer Other
I hereby acknowiedge 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: r
Print Name: Signature 8, R , � Date � vZ�