HomeMy WebLinkAbout800 Grouse Cir - Applications/Reroof - 05/13/2014May 13 14 09:05a . Severe Weather Roofing
970-223-3383 p.1
$ (Z 3- 2 3
Fort Collins
Planning, Development & Transportation
281 N. 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
❑ 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. Incomplete applications will not be accepted.
Application # 814023-+3 Date 5113114
For otixa use only
?ob Site Address (requ/red)
Value of Construction (labor, materials, profit)
800 Grouse Drive
$2100.00
Property Owner Name
Address
City/State . Zip
Phone
Toni Fetter
800 Grouse Drive
Fort Collins 80525
970-217-86
Applicant Name
Address
City/State Zip
Phone
John Anderson
PO Box 2207
Fort Collins CO 80522
970-223-2455
Contractor
Address ,
City/State Zip
Phone
Severe Weather Roofing
PO Box 2207
Fort Collins CO 80522
970-223-2455
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report? 4Here
❑ Report
5025n 5& bya#crxrnactws
Are you paying witty your that account? ❑ Yes ❑ No
Is this a residential or commercial project? VResidential ❑ Commercial
If residential, is it: ❑ Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 yearsof age or more? ❑ Yes ❑ No If yes, you may need to contact HistvdcPresewbon
If this is for a demolition permit, what year was the building constructed?
Ifprior to 1975, you will need an asbestos asseswnent to submit with this application.
Description of work Remove 21 asphalt shingles to decking and replace with 21 asphalt shingles to
*If lawn sprinkler/backfiow preventer, must list licensed plumber. If first-time A/C, roust list licensed electrician.
Subcontractors: List Me company name or aty of Ft C h;ns l?awrse 0
Electrician Plumber Mechanical Roofer
Other
I hereby acknowledge that I have read this application and stage 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 valid until it has been paid and issued.
Applicant:
Print Name: John Anderson signature
Date 5/12/14