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HomeMy WebLinkAbout1142 Sagamore Cir - Applications/Reroof - 06/13/2014aty, of Cor ollins Warming, DevelopmeM Lac Transportation 281 N. College Ave P.O. Box 580 Fort Collins, CO SOS24 157' S 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 Q Demolition Interior non-structural) • 17 Electrical Alteration (not servlce.change) Q Gas Lighter ❑ Gas Log Q Heating Unit El Lawn Sprinkler O Mobile Home replacement d Roofing C3 Sewer Une . ❑ Photo -voltaic O Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must he EPA certdted, provide make, model and manufacturer). Complete all applicable Information on the application. Incomplete applications will not be accepted. AppllCation * 81403110DateFbr a0z am a* i30h Site Address (warW9 Value of ConsRaetlon (labor, materials, profit) imaLW4,MTGlrelev. F Col1�nS o5a� ll,3N`6 Property Owner Name Address City/State Zip Phone I. �� t� ►»a re c�1� o�F�1 s 8� o-w-a5s�t Applicant Name Address City/Stab✓. Zip Phone Q.ns Aso qua-�$►-�i88 Contractor UC # Address. Cdy/State Zip Phone Gala Qcto R I IKaH �. 'VAV r Lrovclt (6 $ `fTo-581-398% ContraCtoi• city dYFL Collins Sales Tax # Are you paying taxes here or by report? 0 Here ❑Report S6iW &Zrmander&nWLmedbyJ11anda&as Are you ping with your trust account? 0 Yes ❑ No Is this a residenti®I or commercial project? 0 Residential ❑ Commercial If residential, is it R Single Family Detached CI Condo/townhome (single family atiarlhed) Q Duplex ❑ Mummify (apartment) 17 Garage If commercial, is it: 17 Bank ❑ ear Cl Church © Hotel/Motel Cl Medical office 0 office C 1 Retain, ❑►restaurant 0 Other (emiplain) Is this bullding 50 yeam of age or more? O Yes ! No Ifyes, you mayneedto mntrd Hbtm rcPresefmdon If this is for a demolition permit, what year was the building censbrucbed? Ifpr/orto 10Y,, you why need anal a -rue mue7tto Bvhimt wrb9 thkappbrdbbn. m`If I3M spimida/baddlow pirevenW, mist list QtensW plumber. If fist -time A/C, must list ricenaed elachidan. 5ubcomtradmmihtMecompWr*v eorC/lyofPtraUnFhbwse ( I hereby acdmowfedge ffmt I have read this appli ation and state that the above information Is oomptebe and correct I agree to Comply with all requimner s contained herein and City ordlri mRr acid sWM laws regulating building cons1ruction. I know brat a permit f9 not valid unb"1 ft has been paid and Issued. . . Prplicaft printtNaame Dow TO/TO 3E)Vd ONI 9NId008 (1709 bZ10E69OL6 91:0I 7TOZ/ET/90