HomeMy WebLinkAbout1818 Jamison Ct - Applications/Reroof - 09/08/2011F6City
t` Collins
Of
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970-416-2740 Fax 22446134
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 Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable information on the application. Incom late a plications will not be acce ted.
Application #
For. offleee tue only
V11
I Job, Site% del res r,iW ufied) . , I; Value�o/)f ruction, (labor, materials, profit) I
,�// / .nA , $ / / / // /
Contractor City of Ft. Coilins.Sales Tax #
Sales tax number Is required by all conftdors.
Address City/State Zip. Phone
Address City/State dip V O (fG /Phone -70 G
Are you paying taxes here or by report? ere ❑ R port
Are you paying with your trust account? ❑ Yes _N11,0
Is this a residential or commercial project? 9::tesidenual ❑' Commercial
If residential, Is ltt ❑ Single Family Detach \ ❑ Condo/townhome (single,family attached) ❑' Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ ,Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office. ❑ Office D Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes ❑ No If yes, you may need to contact HistorIc Preservation
If this is for a. demolition permit, what year was the building constructed?
Ifprfor to 1975, you W11 need an. asbestos assessment to subm/t with this,appllcadon.
Description of work
*If lawn sprinkler/backflow preventer, must. list licensed' plumbs . If first-time A/C, must list licensed electrician.
Subcontractors: Ust the company name or Oty of Ft Collins Ikense if
Eledridan ' 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 v%k until It has been paid and Issued.
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