HomeMy WebLinkAbout2008 Mainsail Dr - Applications/Reroof - 08/23/2011I � Planning, Development & Transportation
City Of 281 N. College Ave P.O. Box 580
®I�t Collins Fort Collins, CO 8524
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 Sto a (must be EPA certified, provide make, model and
manufacturer).
Complete all applic ble information on the application. Incomplete appli�caions will not
be accepted.
Application # lJv Date
For o>fce use only
Sob Site Address (required) Value of Construction (labor, materials, profit)
tqoo� Main , I� $ ayco°�
o rty Owner a Address
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City/State Zip
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Phone 9%a
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City/State Zip
Phone
ntractor Ac# Address
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City/State Zip
Phone
Contractor City of R. Collins les Tax #
Sales tax number is mquired by all wnbactors.
Are you paying taxes here or by report? Caere
Are you paying with your trust account? es
❑ Report
❑ No
Is this a residential r mmercial project? R
If residential, is it: Single Family Deta ed
❑ Multifamily (apartment)
If commercial, is it^ ❑ Bank ❑ Bar ❑ Church
sidential ❑ Commercial
❑ Condo/townhome (single family attached) ❑ Duplex
❑ Garage
❑ Hotel/Motel ❑ Medical office ❑ office ❑ Retail
❑ Restaurant ❑ Other (e la' )
Is this building 50 years of age or more? ❑ Yes
o If yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was a building constructed?
If prior to 1975, you will need an asbestos assessment to submit with this application.
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or rty of R Collins license #
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:
Print Name: Signature
Date