HomeMy WebLinkAbout2826 Paddington Rd - Applications/Reroof - 08/04/201408/04/2014 08:56 19702241211 ROCKY MTN ROOFERS PAGE 01/01
Planning, Development 8R Transportation
i 281 N. College Ave P.O. Box 580
Fort Collins, CO 805241.
Z 3
Phone 970-416-2740 Fax 224-6134
OVE -T or OUNTER PERMITS ONLY
This application Is to be u to ply the following permits only (check all that apply). ❑ Air Conditioning
Q Demolition (interior non-stru 'Ural)❑Electrical Alteration (not service change) ❑Gas fight®r Q Gas Log
❑ Heating Unit Q Lawn Sprin tie Mobile Horne replacementFioofing ❑Sewer Line ❑ Photo-vokaic
❑ Ventilation ❑ Water Heater ❑ Wi iter Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable Info atio i on the application. Incomplete applications will not be accepted.
Applicat)on # 5 Date ic• i-1- 2k (q
farafteuseary
lob Site Address (raqulred) Value osf—C�onrsbuuctlon, `clabor, materials, profit)
n
Property Owner Name
Address
City/State
Zip
Phone
-17
--6 314.Oct
Applicant Name
Address
City/State
Zip
Phone
contractor LiC #
-1
3 Address
City/State
Zip
Phone 0 10
LA�5,U(\
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Contractor City of Ft. Collins Siles
T
ix # y t
Are you paying taxes here or by report? ❑ Here
Report
.sales *W tUmber is regnlrVd by sa
Are you paying with
your trust account? J# Yes
❑ No
Is this a residential orEMU
me I p )!i'J Residential ❑ Commercial
If residential, Is (t: ngle amoy Datached eondo/townhome (single family atliched) ❑ Duplex
ldfa ily (a arnent) 0 Garage
if commercial, is It: O Bank Bar ❑ church ❑ mow/Motel 0 Medical office ❑ Office Q Retail
❑ Raestau nt ❑ Other (explain)
Is this building 80 years of or rr ore? Q Yes O No Af yr+s, )qw may creed to cons Set Hls&wfc Freservatlon
If this Is for a demolition It, wliat year was the building constructed?
if pnbr to 1975, yt w W11 need aSD#SW5 amwssmCnt to submit wlOh this appllcaton.
of Work
*If lawn sprinkler/backflow
subcontractors% Ust fire i
gectridan
I hereby acknowledge that I
comply with all requirements
permit is not valid until It
Applicant:
Print Name: mN
. J
t list licensed plumber. If first-time A/C, must list licensed ek6lcian.
oratyofFtCoftsAcense0 vk1 uC..e V.0+ha�$.
Medtanical Roofer Other.
read is applicatioh and state that the above information is complete and correct. I agree to
fined herein and city ordinances and state laws regulating building construction. I know that a
bee paid and issued.
Signature
500�mffis
TYu57 NcLoun+