HomeMy WebLinkAbout7133 Ranger Dr - Applications/Reroof - 10/11/2011lI-
va va4-,
,Oct of,
Planning, Development & Tranap
281 N. College Ave P.O. Banc 58l)
Fort Collins, CO 80524
Phone 970-416-2740 Fax 22+6134
OVER-THE-COUNTER PERMS ONLY
This application Is to be used to apply for.. the following permits only (cheek all that apply). 0 Air
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not sexy'Ips
change) ❑ Gas Lighter ❑ G
❑ Heating Unit ❑ Lawn Sprinkler b Mobile Home replacement ErRoofing ❑ Sewer Line ❑ Photo
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ WoodlPeliet Stave' (must be EPA certified, provide nu
manufacturer).
Complete all applicable information on the application. Incomplete applications will not be accei
Application #92 �
Date _
i AA t r)
..
IiiTLF-I
Sob Sfte Aillciress (edJ
Value of (tabor, materialp,
profit)
Con
Property Owner Name Address
i� -7(3
City/State Zip
phone q 70
dvi e✓
Applicant Name Address
City/State Zip
Phone
Contractor Address
6ty/State Zip
I Phone ZQ3
r 3
o a co 1000
I %4 3
Contractor City of FL Coigns es Tax #
swstax r ebyagneod2m
Are you paying taxes hereor by report? 6K
Are
❑ Retort
�yRgara
,�s
You paying with Your but account? 0 �
rXNo
Is this a residential or commercial project? E� Residential ❑ Commercial
If residential, is it: ❑ Single Family Detached ❑ Condo/townhome (single family attached) ❑ Dupl
❑ Multifamily (apartment) ❑ Garage
If commercial, is It: ❑Bank ❑Bar ❑Church ❑ Hotel
/Motel ❑ Medical office ❑ office ❑ Retail (j
❑ Restaurant ❑ Other (expia!
Is this building 50 years of age or more? U Yes No If yeFyou may need to wWVa HistWfC
If this is for a der olition permit, what year was the building constructed?
Ifprmr to 1975, you wU/need an asbestos assessrnpnt to -Qdm t Kwb & s app oeabba
*If lawn sprinider/baddlow preventer, must list lioeraed pl . If first-time A/C, must list licensed eleWidan.
Subcontractors:- List thecoaWanynow orLitt'dfftCaJCv Amm #
Bacbidan PlurttbMed=*W Roofer C
I hereby admowledW that I have read this application and state that the above information is complete and
comply with all requinernents contained herein and: city ordhances and state laws regulating building constm
permit Is not vaN untH 0 has been paid and issued.
Appficant:
Prim Itsm
I agree to
mow that a