HomeMy WebLinkAbout5807 Pleasant Hill Ln - Applications/Reroof - 07/31/2014 (2)07/31/2014 09:51 19702241211 ROCKY MTN ROOFERS PAGE 01/01
A•, Planning, Development &Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970-416-2740 Fax224-6134
OVE !4 ErCOUNTER PERMITS ONLY
This application is to be usec to iy for the following permits only (check all that apply). ❑ Air Conditioning
❑ Demolition (interior non -afro rat) ❑Electrical Alteration (not service change) ❑Gas Lighter ❑ Gas Log
0 Heating Unit O Lawn Sprin er Mobile Harm replacement �' hoofing ❑ Sewer Una ❑ Photo-voltaic
lventilation ❑ Water Heater ❑ W er Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer). `
Complete all applicable info to on the application. incomplete applications will not be accepted.
Application # �Li 3 bate - " ► W
For of!tce use
Sob Site Address Owulred)
Value of t onstructfon (labor, materials, profit)
�4 le�sotin
L e
- M '.. oc3
Property Owner Name
Address Clty/State Zip Phone
Applica me
Address City/State Zip Phone
Contractor Uc #
r
tr i
-1
3 Address City/Stage Zip Phone CI 10
5 . u r_>� zZa-,Zoo
Contracbor City of Ft. Collins 54
,saes taaraumIWi F r WA9d bya9 W
les T4x
# �i } '�"1l Are you paying taxes here or by report? ❑ Here Report
Are you paying with your trust account? Yes ❑ No
Is this a resideridal or com
1 p
? 1j Reslder►dai El commercial
If residentia1,15It: �irSingle
amity
Detached Cl Condo/townhome (single family attached)' 0'Duplex
❑ Muldfailly
(apartment)
❑ Garage
If commercial, is It: ❑ Bank
3 Bar
❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Pwstaui
3nt
C3 other (explain)
Is this building SO years of ag
or
7 ❑ Yes ❑ No Ify44 you may need to contact Hisior/c Preservation
If this Is for a demolitlorr
It,
year was the building constructed?
Irprior to 1975. you w///need
awezmencto submit wiM this appl/cadon. 1
IZOA
*If lawn sprinkler/backnow D ter, n iust list licensed plumber. If first-time A/C, must list licensed
subcontractors: L6tffieoompzqynar7e or ply of FtCaff1ns1xww 0 CX'a'Z � bs-t$
Electrician Plu r Mechanical Roofer
I hereby acknowledge that I
comply with all requirements
permit is not valid until it
APPIIcant:
Print Name:
read application and state that the above Information is complete and Correct. I agree to
pined Welm and city ordinances and'state laws regulating building construction. I know that a
been oaid and issued.
Signature
Irate ' - 3 1-1 Li
—Fm57 plat oun+