HomeMy WebLinkAbout3300 Stanford Rd - Applications/Reroof - 10/19/201110/20/2011 01:56 3032962517 EH COMM & COLO ROOF PAGE 02/02
Citybf Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Flirt Collins Fart Collins, CO 80524
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 A15oofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application #V 0461-
For office use only
Date '01y /o' c5i 1
.... (required)
Value of Consbructionr• profit)
14
Property Owner Name
U. Address
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Applicant Name Address
CitV/State Zip
Phone—*W-il
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Contractor 1.
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Phone
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:/. ram• /� .�Conitractor
City of R. Collins Sales Tax #
Are you paying taxes here or by report?
kHere 0 Report
Is this a residential or commercial project? `Q F
If residential, is it: ❑ Single Family Detached
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 (explain)
Is this building 50 years of age or more? ❑ Yes `JtNo If yes, you may need to contactHisti JX Preservation
If this is for a demolition permit, what year was the building constructed?
Ifpnor to 194 you will need an asbestos assessment to submit with this applicaDon.
of work
*If lawn sprinlder/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or QyofFt Collins /,tense #
Electrician Plumber Mechanical Roofer
Other
I hereby acknowledge that I have read this application and state that the above information is complete and correct. 1 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. 11---�
Applicant: i ( M':(� nt'�J
Print Name: '
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