HomeMy WebLinkAbout3014 Avena Ct - Applications/Reroof - 08/19/2014Fort of
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
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) D Electrical Alteration (not service change) O Gas Lighter ❑ Gas Log
❑ Heating Unit O Lawn Sprinkler D Mobile Home replacement 91 Roofing D Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater D Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
manufactur
Completea58
pl bl to ti o!I"ication. Incomplete applications will not be accepted
Application to 1 91
For office use only
lob Site Address (required)
Value of Construction (labor, materials, profit)
P In. G.
30SZ 21 f
Property Owner Name Address
City/State Zip Phone
1 a
FA 01106 lZ00Th ago - gcnQ
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Applicant Name Address
City/State Zip Phone
Contractor Address
City/State Zip Phone
CAPITOL ROOFING INC. 6540 S. COLLEGE
FORT COLLINS 80526 970.223-56o0
Contractor City of FL Collins Sales Tax u
Are you paying taxes here or by report? Here ❑ Report
sales tar number is recuired by as contactors.
Are you paying with your trust account, ❑Yes No
Is this a residential or mmercial project? &-Residential ❑ Commercial
If residential, is it: Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
c
❑ Multifamily (apartment) D Garage
if commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑Medical office ❑Office D Retail
❑ Restaurant O Other (explain)
Is this building 50 years of age or more? ❑ Yes ii 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 app/ication.
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Description of work
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`If lawn sprinkler/backnow p eventer, must list licensed plumber. If first-time A/c, must list licensed electrician. i
Subcontractors: List the company name or City of fs Collins license a flI Vr5
Electrician —
Plumber Mechanical ---Roofer l`yl('( N �� Other
t 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: Date _..
Print Name: CAPITOL ROOFING INC Signature __ _—
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