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HomeMy WebLinkAbout1230 Patterson Ct - Applications/Reroof - 09/01/2011SEP/01Y2011/T6U 01:25 PM q�7 Fa t�Cottins FAX Ro. P. 00.5' 311 Planning; Development & Transportation 281 Jd. College Ave P.O. Box 580 Fort 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 0 Demolition (interior non-structural) p Electrical Alteration (not service change) 11 Gas' Lighter ❑,Gas. Log Heating Unit U Lawn Sprinider 13 Mobile Home replacement )URooflng O sewer Line 0 Photo -voltaic O Ventilation ❑ Water Heater O Water Line U Wood/Pellet Stove'(mustbe EPA certified, ,provide make, model and manufacturer). Complete all.applicable information on the application. Incomplete applications will not be accepted_ Application # bla to �� Date —l� 1 k2ok l For ofike ase only �— Job Site Address &Wulred) Value of Construction (labor, materials, profit) Property Owner Nance Address City/state Zip Phone Oncr Applicant'Name Address City/State Zip Phone Contractor Address City/State Zip Phone Contractor 0ty of Ft Collins Sales Tax # s%riwmha isnog hedbyal/aaobaallas Are you paying taxes here or by report? Here Are you Wing with your trust account? Cl Yes O Report . 13 No Is this a residential or commercial pmjed? 0 Residential L3 Commercial If residentialjs it: 1! Single Family Detached Cl Condo/townhome (single family attached) 0 Duplex 13 Multifamily (apartment) ❑ Garage If commerdai, Is it: © Bank ❑ Bar , T Churrh Q HoteJ/Motal O Medical office 13, Office ❑ Retail O Restaurant d Other (explain), Is this building 50 years of age or more? O Yes ❑ No :A`M ynu may netnd to cantactH ncPreservalfon If this is1br a demolidon ,permit, what year was the building constructed? Ifpnor to 1975, you Wff need an asbestos assenumt M:sabmk gM drk apclkabon of work k *9 lawn sprinkler/baddlow preventer, must ilst licensed plumber. If firs[ time A/C, must list kern electrician. Subcontractors: I& the company name or CRy oFFtColllns hbwm;0 Ele&dm Plumber _ Mechanic! Roofer= _ Other I hereby ativtowledge that I have;read this.appiicadon,and state that the aboveinformation is complete and correct. I agree to comply with all requirernaft rontained'herein:and city ordinances and state laws regulating buildingconsbuction. , Z know that a permit is not valid until it has been. pald,and Issued. Applicant: 1 i Print Name-Altv Signature 4�2Date _ T�e''/¢i�Pl r errfamn sv 6 - �E�F