Loading...
HomeMy WebLinkAbout5117 Parkway Cir W - Applications/Reroof - 07/31/2014Application # OLA-1 For office use only Jul. 31, 2014 12:54PM Roof Works, LLC No, 0998 P. 4 Planning, Development & Transportation city. of 281 N. College Ave P.O. Box 580 art Fort Collins, CO 80524 Phone 970-416-2740 Fax 224-6134 OVER-THE-COUNTER PERMITS ONLY This application is to be used to apply for the following permits only (check all that apply). 13 Air Conditioning ❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log ❑ Heating Unit Q Lawn Sprinkler ❑ Mobile Home replacement M 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. ka1 4 Date 07/3112014 Job Site Address (wubed) Value of Construction (labor, materials, profit) 5117 Parkway Cir W., Fort Collins, CO 80525 8290.00 Property Owner Name Address City/State Zip Phone Kellh Troudt 5117 Parkway Cir W Fort Collins CO 00525 970-226-3570 Applicant Name Address City/State Zip Phone Contractor Address City/State Zip Phone Roof Wont, LLC 12301 N Grant St., Ste 130 Thomton, CO $0241 303-353-1825 Contractor City of Ft, Collins Safes Tax # Are you paying taxes here or by report? IN Here ❑ Report $Westax number isrequiredbya#condactws Are you paying with your trust account? ❑ Yes ® No 60640 Is this a residential or commercial project? ® Residential ❑ Commercial If residential, Is It: ® Single Family Detached © Cando/townhome (single family attached) ❑ Duplex ❑ Multifamily (apartment) ❑ Garage If commercial, Is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office 0 Office ❑ Retail ❑ Restaurant ❑ Other (explain) Is this building 50 years of age or more? 0 Yes 0 No If yes, you mayneed to contact HLstorlcPreservation If this Is fora demolition permit, what year was the building constructed? If prior to 1975, you will need an asbestos assessment to submit with this appllcation. DescfipUon Of work Remove Existing Shingle and Replace wilh 23 aquarea of GAF Timberline Hb *If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician. Subcontractors) List the company name or 05 y of Pr Collins license 0 Electridan Plumber, Mechanical Roofer R-2165 Other 1 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: Edward L Thomm Signature site 07/31/2014