HomeMy WebLinkAbout5212 Iris Ct - Applications/Reroof - 07/24/2014Planning, Development & Transportation
City Of 281 N. College Ave P.O. Box 580
Fort Collins Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
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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 # �61 L+CL4-7 y 9 Date —I 1 e�i �i -
For o>hce use only
Job Site Address (required)
Value of Constructigg (labor, materials, profit)
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Pro Owner ame Address
City/State Zip Phone
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Applicant Name Address
City/State Zip Phone
Contractor Address
City/State Zip Phone
CAPITOL ROOFING INC. 6540 S, COLLEGE
FORT COLLINS 80526 970-223-5600
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report? t331ere ❑ Report
Sales tax number is required by all contractors.
Are you paying with your trust account? ❑ Yes Wo
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Is this a residential or commercial project? 'residential ❑ Commercial
If residential, is it: WSingle 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 years of age or more? ❑ Yes "o If yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
If pnor to 1975, you will need an asbestos assessment to submit with this application.
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*If lawn sprinkler/bac ow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or City of Ft Collins license # A t V is can n`C
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Electrician Plumber Mechanical Roofer Other
I hereby acknowledge that I have read this application and state that the above information is complete and correct. I agree to
comply with all requirements contained herein and city ordinances and state la s re lating building construction. I know that a
permit is not valid until it has been paid and issued.
Applicant:
Print Name: CAPITOL ROOFING INC. Signature Date