HomeMy WebLinkAbout1725 Barnwood Dr - Applications/Reroof - 10/19/2011®VCR 14
Planning. Development & Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
""uUNTER PERMITS ONLY
This application is to be used to apply for the followin
13 ❑ Demolition (interior non-structural) ❑ Electrical Alteration permits
not seryi�change)
all mat a
Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement O R p�ye ❑ Air Conditioning
❑ Ventilation ❑Water Heater ❑Water Line Gas Lighter ❑ Gas Log
Ong ❑ Sewer Line ❑ Photo -voltaic
manufacturer). ❑ Wood/pellet Stove (Must be EPA certified Complete all applicable info►mation on the a� make, model and
applicationde
Inconlpiet
Application #
alke Use only
SobS�itte Address (equIr
/%
T
Owner Name
'ro
Wlk�nt Name
Contractor City of Ft. Collins Sales Tax #
Saes iar rxurfr n-' edby a//�a<mrs
e applications will not be accepted.
Date '- •�'_ Ali i
Value of Construction (labor, materials, profit)
.� 'n , �
atY/State AP)
� Prone 70
Address GtylState
Zip � Phone
Address CRY/State Zip Phone l /_�__
Are you paying taxes here or by report? Here
Are you paying with your trust account? ❑ Yes
Is this a residential or commercial project?
If residential, is it: ❑ Single Family idential ❑ Co►►�mercial
❑ Multifamily (apartment) ❑ Condo/townhome (single family attached) ❑ Duplex
If commercial, is it: ❑ Bank ❑ Bar ❑ Churth ❑ ryas
❑ Restaurant ❑Other oteVMotel ❑ Medical office ❑
Is this building 5o years of a (explaippp ) Retail
If this is for a demolition or more? O Yes No If yes, you may Iced to con Ifprior 01975 ���' why Year was ilding constructed? tacCHistpricP vatron
Wu
wi// r an ate- a neat k� Subm/t wibh phis aP--2iorx
Description of work
❑ Report
ANo
*If lawn spdnklerYbaddiow Preventer, must list lioensed plumber. If first-time NC, �must list licensed list Ure cnir nY name or City of a Collins /icerese # ekxbician.
' Plumber _— Munka!
Roofer other
herebacknowledge that I have
ompy with all 'conta this application aril state that the a
rrecL I agree to
ermit is not ralid� u been herein and city ordinances and bone infom�ation is complete and
Paid and issued, state laws regulating building consbuction. I know that a
Pplkant: r, /
Tint Name:' ,
SiOnatu i Date J�