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HomeMy WebLinkAbout6914 Egyptian Ct - Applications/Reroof - 11/28/2011f ;j o f Plonningr DevelopnNht a TIMnsPortadon 281 N. College Ave P.O. Boat 580 Fort Collins, 00 80524 Phone 970-416-2740 Fax 224-6134 OVERLTHE-COUNTER PERMITS ONLY This aWleallon Is to be used to apply for the following psrmit4 only (check all that apply. 0 Air Conditioning O Demolition (interior non-structural) 0 Electrical Alteration (not eervlce change) 0 Gas Lighter 0 Gas Log 0 Heating Unit 0 Lawn SpMnktbr 0 Mobile Home replacement 0 Roofing O Sewer Line ❑ Photo -voltaic 0 Ventilation 0 Water Heater © Water Line 0 Wood/Pellet Stove (must be EPA certified, provide make, model and manufacturer). Complatt all applicable hWorml■Non on the adplieelon. Incomplete applications will not be accepted, Application Date — 1 1 �7J • �1 ror chiles roc a* lob Site Ad6 esa &Wuked) 6g1V ii copicy-� Value of Co-1-b u •q0 labor, materials, profit) $ -2 ,a,^��� Owner Name Address City/ tabs Zip Phone Name Address City/stateZiPhone Contractor IJC # Address ContmCbor City of FL Collins Sales Tax # ALW aw non&&-Ismawftdbyari+aan&*ftx city/state Zip Phone Are you paying taxes here or by report? 19Here 0 Report Are you paying with your trust account? 0 Yes D No Is this a residential or�eorn al project? 01feddenttal O Commercial - If Midential, Is It: SL9" Ingle Family Detached 0 Condo/townhome (single family attached) O Duplex ❑ Multifamlly (apartment) O Garage If commercial, Is it. ❑ Bank O Bar O Church ❑ Hotel/Mobs) 17 Medical office O Office ❑ Retail 0 Restaurantl O Other (eocplain) Is this building 50 yam of age or more? D Yes Q No Dyes, youmayneed to a ntactH/store>fwvat!on If this is for a demolition permk what year was the building constructed? 1rpobr to 1975, you w111 need an a0estas asseswwnt to subm/t Phil ails aAo/%abbn of work *If lawn sprinkler/bacldiow pnwe rater, must list licensed plumber. If Rrst time A/C, must list licensed electrician. Subcontractors: Ust aria cmAwy name or 01!y orm Colons lkffm 0 Bectrida Plumber Mechanical Roofer Other I hereby acknowledge that I have reed this application and state that the above Information Is complete and correct I agree to comply with all requirements containld herein and city ordinances and state laws rqgulating building construction. I know that a pencil Is not valid until It has bean pail and Issued. . PApplicant: ZZDaft