HomeMy WebLinkAbout500 Sundance Ct - Applications/Reroof - 03/09/201203/09/2012 14:04' 9703305645 SLAUGHTER ROOFING PAGE 02/04
.Ciof Collins
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970-416-2740 Fax 22+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 Cl. Gas Log
❑ Heating Unit ❑ Lawn Sprinkler Cl 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 anplication. Incomplete applications will not be accepted.
Application # � I A a5 L4 Date
For o9ire use only
Is this a residential or commensal project? 0 Residential ❑ Commercial
If residential, is it IN Single Family Detached ❑ Condo/townhome (single family attached) Q 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? O Yes )al No If yes, you may need to contactNrstonc, preservation
If this is for a demolition permit, what year was the building constructed?
Ifpr/or to 1975, you WI/ need an asbestos assessment to submit wlrh this application.
Description of work
*If lawn sprinkler/baddlow preventer„ must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors; List the Company name or Cty of ft Collins //tense #
Electriclan 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 laws regulating building construction. I know that a
permit is not valid until it has been paid and issued,'
Applicant -
Print Name: Signature Date
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