HomeMy WebLinkAbout843 Sandy Cove Ln - Applications/Reroof - 08/11/2014Planning, Development & Transportation
City of 281 N. College Ave P.O. Box 580
Flirt Collins 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). ❑ 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. 3
Application # b. I � Date
For office use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
Cove
l,/-,J
Property Owner me
rt� "SCAJIs
Address City/State
`i3 �n cove Li
�{c
Zip
�'AS
Phone
9 1- ie
nt Name
Address
City/State
�
Zip
7qiz-zz,
r,urc,� CGCe�-s
LT
�5�CK s�
�
o�
Contractor
Address
City/State
Zip
S
Phone
`f1Z - 20
C)
Contractor City of Ft. Collins Sales Tax #
Sales tax number is required by all contractors
Are you paying with your trust account?
❑ Yes ❑ No
Is this a residential or commercial project? (;� Residential ❑ Commercial
If residential, is it: ❑ Single 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 ❑ No if yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
if prior to 1975, you will need an asbestos assessment to submit with this application.
Description o work�T�l}� - I N
*If lawn sprinkler/backnow 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 #
Electrician Plumber Mechanical Roofer X 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:✓emu
Z
Z