HomeMy WebLinkAbout3742 Bromley Dr - Applications/Reroof - 08/12/2014Aue,12, 2014 12:45PM ADVANCED ROOFING No•7471 P. 11
City. of Planning, Development & T'ransportation
281 N, College ,Ave P,O. Box 580
Flirt Collinsl.. Fort Collin, CO 80524
�w..r Phone 970-415-2740 Fax 224.51s34
OVER, -THE -COUNTER PERMITS ONLY
This application is to be used to apply for the following Perm its only (ot;eck all that apply). C Air CGndironing
❑ Demolition (interior non^structural) ❑ Electrical Aitera;ion (nOi serVlcs change) Q Gas i ighter Gas Log
Heating Unit Q Lawn Sorinkler C Mobile Nome replacement hoofing a Sewer Lire u Photo -voltaic
Q Ventilation C Water Heater ❑'Alater Line n Wood/psilet Stove (
manufacturer). must be 5PA certified, provide make, medal end
Complete all applicable information on the application, incomplete applications will not be accepted,
r+j]pI(CataGR rS�1 Delia
For office use oily — —
]ab Site 4ddress
Property Owner Name Address
ppilant Name Q Address
0V f4-ivGEQ RDDi+ITOc= _
Contractor lac = Address
Contra= City of Ft Collins Sales Tax r
<a/es tix numur is re.7ug-ed ty all cor,&a=7rs.
��io5la
Zaiue of Cons",
!labor, rneteriais, profit)
t 2 �a r, oa
Coll; tiS SIP G��9i5 Phone
'*bA
zip
City/Sire za
w.l
75
Phone C�p
Phone
fire you paying taxes here or by report? ❑ Here Q Report
Are you paying wit' your gust account? Q Yes ❑ wo'
s this a residential or commercial project? xResidenbai Q Commercial
IPresidential; is it; > Single':camily Detached" L'7'Cer1'do/townfib fie (siri5le fzr ily attacted) Q Ci6plex'
C] Muitifamiiy (apaCanent) Q Garage
If commercial, is It: ❑ Bank ❑ Bar ❑ Church ❑ ,Hotel/Motel ❑Medial once ❑ CM, ce ❑ REiz it
!� Restaurant ❑ Other (explain)
Is this. building 50 years Of age or more? ❑ Yes Q No .Ifyes, you may neeo"fp.ontac"r/scrycPrrseriacor�
If this is fir a demolition permit, what year was the building constructed?
lfprior t.0 J975, you will need an asbes-os assess ent to submit vlt5 ;his app(icabcn.
bescriptlon of wod<
*If (awn sprint er/baddlow preventer, must list licensed plumber. If first-time A/C, must list i[censed
5ubcentraders: Li<titeconpenyname crCitycrFcCpl/fs/lcrose r
E!e�idan Plumber Mec ar[ca(� V,416 �
_ Rcfar/� �_,r
Other .
i' Hereby acknowledge that I ,have read this applicabon and state t"at the above information Is com-fete and correct. I agree to
cor;'piy with.all requirements con�ined herein and city ordinances and st-,te laws regulating building cons�ruction, I know that a
permit is not valid until it has been paid and issued,
Applicant:
Print Name: Signzture
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