Loading...
HomeMy WebLinkAbout1324 Stover St - Applications/Reroof - 01/03/2012� r Planning, Development & Transportation City of 281 N. College Ave P.O. Box 580 F:6 t Collins'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 ❑ Demolition (interior non-structural). ❑ Electftd Alteration (not service change) ❑ Gas Lighter ❑ Gas Log ❑ Heating Unit ❑ Lawn Sprinkler O Mobile Home replacement lkRoofing ❑ Sewer Line ❑ Photo -voltaic ❑ Ventilation ❑ Water Heater ❑ Water Llne ❑ 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. # Z2_000 a.^7 Date For ofifce use only job Site Address (required) I Value of Construction (labor, materials, profit) I is this a residential or commercial. project? 11,Residential ❑ Commercial If residential, Is it: 16 Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex ❑ Multifamily (apartment) ❑ Garage If commercial, Is It: ❑, Bank , ❑ Bar ❑ Church ❑ Hotel/Motel © Medical offlce ❑ Office ❑ Retail ❑ Restaurant CI Other. (explain) is this building 50 years of age or more? ❑ Yes 'A No If yes, you may need to contact HIstoric Preservat/on If this is for a dernalition permit,'what year was the building constructed? If prior to 1975, you will need an asbestos assessment to submit wfO this application. preventer, must list licensed plumber. If first-time A/c, must list licensed electrician. Subcontractors: Ust the company name or Gty of Ft C011117S Ilcense If Electrician Plumber Mechanical_ ___ Roofer Other_ I hereby acknowledge that I have read this application and state that the above information 1s complete and correct. I agree to comply with all requlrements contained herein and .city ordinances and state laws, regulating building construction. 1.know that a permit is not valid until it has been paid diid issued. APPlicant: 115 Print Name: (rl r 1 l 1L�1(�%—Signature bate