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HomeMy WebLinkAbout5336 Fossil Ridge Dr - Applications/Reroof - 08/14/2014Aug•14. 2014 12:OOPM ADVANCED ROOFING No,7513 P. 1 City, of j j p� Ptanningr Development & Transportation ,F6rt Collins For N. College Ave P.O. 9CX 580 Fort Collins, CO 80524 Phone 970-416-2740 Fax 224-5134 AVER -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-st:vctural) Cl Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log C w Heating Unit a Lan Sprinkler Q Mobile Nome replacement D Rooting u Sewer Line G Photo -voltaic m Ventilation Q Water Heater ❑Water Line Q VVocd/Peifet Stove (must be EPA crtifled, provide make] model end artuf urer}. e Compt all[Jib�s- pl � r ati n ' app ation. Incamplete applications will not be accepted. 'CJ App(i n Date F 4� -- For oPicn use or,/y Sob Site Address (req✓! ) 1 Value of ConSt ucfon (labor, rateria!s, prof») Prepe, . Owner Name Address Cis f/S Gte o' �r!►�S Z;pOASPhone `� i G �pliWit Name Q cdresc Cty/State (��SV H 1�5C:Ep l�D0 F I NC= p • Phone Grz ZC � zi Contractor Lc # Address Cfi//S t= Zip Phone Contractor City of Ft. Collins sales lax x Are you paying taxes here orb ,��cr? 'aJes�xnumh -urM 'by a//dnra�rs. a Y r D Her_ Ci Repor•, cCiDSId Are you paying with your Cuss account? .D Yes ❑ No . Is this a residential or commerdei projEt- ? Residential ❑ Commer-ial If restdenti2l is it, SIngle Family Detached O Condo/tcwnF o(ne (sihte arrily at o'ched) ❑ Duplex ❑ Muitlf rn- HY (apartment) ❑ Garage If comnerclai, is it: C] Bank ❑ Bar ❑ Church ❑ HeteVMctei Cl Medical cf ice ❑ ORce ❑ Retail this 1� © Restaurant ❑ Cther (explain) - thi Is s •bulldirg 50 years of age or more? 0 Yes ❑ No tf yes, ycu mey neee-Ltcontac-H/stork preserrarron If is for a demolitloir permit, what year was the building constructed? If prior to 1975,, you wyN need aq asbestos assessrient to submit with GSis app(icaton. Description of work If lawn spr;nkier/bacWlow preventer, must Itst licensed plumber. If first-bme AJC, must � hs Licensed _,,,c�rfean, Sulcontracters:listfeconpenyrenecrC/h/of FrCc//irslTc_=ns8: �� !� E!eC,r'dan Plumber C y _ Ne.,aMcal^ Rcafer Other Phereby admowfedpe that I have read this application and state at the above information is cornelete and Correct. I agree to comply with•all requirements cer:i4ined here!n and city ordinances and st: to laws re- !ating building cons , lotion. I know that a permit is not valid until it has been paid and Issued, Applicant: Print Name:i� r aUR�MR Signature r � /, ' Li Data ✓ � C r