HomeMy WebLinkAbout6344 Compton Rd - Applications/Reroof - 10/21/2011to: rLum: M5111ey r11LLd111 lu-i[1-11 0 ; codill P. C UL j
JTV 0; Planning, Development & Transportation
F&t Co[tins 281 N. College Ave P.G. Bcx 580
Fort Collins, CO 8052-
Phone 970-416 212110 Fax 224-6134
OVER-THE-COUNTER PERMITS UNLY
This application is to be used to apply for the following permits only (check all that apply)- D Air Conditioning
D Demolition (interior non-structural) 0 'Electrical Alteration ('lot servirr, change) F- Cas Lighter 7- Gas Lore
D Hearing Unit Ll, Lawn Sprinkler Mohilie Home replacement X Roofing ` Sewer Line L-31 Photo -voltaic
JiI Ventilation F! Water Heater MI Water Line P. Wood/Pellet Stove (must be LPA certiflcd. Prov;ric make model and
manufacturer).
Complete all applicable information on the application. Incomplete applications will not be accepted
Application C CC5C7
For Office use only
Date
Job Site Address (reqijiiecp
Value of Construction !labor. flaietials, uryfit)
li M C, M-t-Au. K d
property Owne- Name Address Citv,'S'ate zip Phone
IApplicant Name Address City/State Zip Phone
A N
City/State Contiactor Address
Zip Phone,
L)
TL:33
Contractor City of Ft. Collins Sal ti Are. you paying taxes here o.- Ily reoort:? �7) Report
Tax
Sdk, iijx Are you -,)ay;,,)g with vo,.jr Irus, account? C yes No
Isthis aresidential orcoginercialp-roiect? VRP.sidential 0 Cornmerdail
If residential, is it: �OS;rrgle Family Detached 0 Condo/townhome (single fa attached) %; D I e X
x h L❑-J F
0 Multifamily (apartment) El Garage
If commercial, is it: C1 Bank 0 Bar 11 Church. 0 Hin,-elftiote! [j- `,tedicaljrjc.o rL7 office El Retail
Restaurant 0 ')
11ther (explain'.
Is N11S building 50 years of age or
r9cre? F-j Yes X No J! yeS,
If this is for a demolition permit, -vilat year was ;he budding constructed?
Il'PrOr to 1915, you will needao i5i7(NtOs gs";Osslri to submir witl� bj
Pp
---- — ------
Description of Norte
LL—
"if lawn spi-irkier/nackflow p,,ever-.ji,r. .must liq! ijcellscf' plumber. If filst-truie AiC, oi.ist list li r sed 1.:(-(:!rician.
Subcontractors: -L-V /he coviwuw 0" Chl 11" Ft coffins ficensc
Electrician,I"u: goerior.
or
I hereby aLkilmmedoe tha! f nave read this applw-ition and (ii-Dt 4 a, tqe dbovc rIn! niMion :s mirp;�,je. an� c, agrl-k:
LC Lh
COmP1Y w:Ill ali requirerrient, contlined herew and. cify oidinances and stale "'"s: , n know that a
permit is not valid until it has been paid and issued.
Applicant:
Print Name: VItl- Signature
Date LL2 U