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HomeMy WebLinkAbout3338 Sharps Ct - Applications/Reroof - 09/15/2011Sep 14 11 03:35p 5 Star Roofing Co.,LLC 970-663-7827 p.1 OVER-THE-COUNTER PE RIU►iT'S ONLY This application is to be used to apply for the following permits only (check all that apply), O Air Conditioning 0 Demolition i(interior non-structurai) 0 Electrical Alteration (not service change) 13 Gas lighter ❑ Gas Log ❑ Heating Unit ❑Dawn Sprinkler O Mobile Home replacement jq Roofing ❑ Sewer Line ❑ Photo -voltaic ❑ Ventilation O Water Heater 11 Water Line O Wood/Pellet Stove (must be EPA certified, provide make, model and manufacturer). Complete all applicable information on the application. Incomplete appiicatipns will not be accepted. AppliCation # I I 0 (0 1 Date 9 Ins I I For of 7w ose only Z 'F., 9L2 .� Job Site Address (require Pro,fJtV Owner Name �pplimnt Name ��_r K��J11 hLiV Contractor Uc # i Contractor City of Ft Collins Sates Tax # Salesbxm grWiffredbyJ#mnftcmm of Construction (labor, materials, profit) Address CRY/State Zip �m � �(I /'Zr,7 p o Address CiWS((tate i p Phone /I J3So #? _i <'r �'��Pluru(� CD� � / fPl- Address Oty/Sta{e zip Phone 6-fit51. 'fWAL-1 rn <711r 1 -7 /.1 -7 Are you paying taxes here or by report? D Here JL Report Are You Paying with your trust account? rj Yes ❑ No Is this a residential or comm_CrdW project? @Kesidential 0 Commerdal If residential, is it EISfingle Family Detached 13 Condo/townhome (single family attached) ❑ Duplex ❑ Multifamily (apartment) E3 Garage If commercial, Is It ❑ Bank ❑ gar ❑ Church ❑ Hotet/Motel © Medical office O OfFce O Re�il- 0 Restaurant ❑ Other (explain) Is this building 50 years of age or more? O Yes ❑ No IfYes, You mayneedlo cnnlacty1sfiricP1;ese1vabr0n If this is for a demolition permit, what year was the building constructed? Ifprior to 1973, You w/Oneed an asbestasassessment lo submdWith fbts aPe/io60n t:S1 V lawn sprfnkler/backfiow preventer, must list Ifcert plumber. TV first-time A/C, must list licensed electrician. Subcontractors: Lostb`re cornpanyaame or City offtCollins oicensig g Electricran' Plumber Medfanlol� Roofer - r�t` Other I hereby acknowledge that I have read this appHuadon and state that the above information is complete and carre.ck 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, n Applicant Print Signature Name : + Date