HomeMy WebLinkAbout1208 Cascade Ct - Applications/Reroof - 03/22/2012To: 19702246134 From: Ashley McLain 3-22-12 1:54am p. 3 of 5
Planning, Development & Transportation
F®rCo ins For Collins,College Ave P.O. Box 580
j l Fort CCO 80524
Phone 970-416-2740 Fax 224-6134
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 applicationswillwill not be acd.
Application #bi 0 Date - -i r�k to.-A15
Forofi9ce use only
Sob Site Address (required)
Value of Construction (labor, materials, profit)
mscode ruitt
c -1 J .
Property Owner Name
Address City/State Zip Phone
t2D8 CiiXiSSC C . �F . Cnilins . St�21 2.10, �ZqB
Applicant Name
Address City/State Zip Phone way
257o a .8 C.Dmwf 41 Ai- d1#26
Contractor
prewff
Address City/State Zip Phone
2�37®. 0°8:* #MM ° WV4W ft2b4 Z3fj?U#5
Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? )Jiere ❑ Report
trust ❑ Yes )No
Saks tax nurpper red by all contractors
Are you paying with your account?
Is this a residential o co mercial project? residential ❑ Commercial
If residential, is it:ingle 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 )4o If yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
Ifprior to 1975, you will need an asbestos assessment to submit w1th this application.
Descrip i n of work
0 5 (lQ. t.
*If lawn sprinkter/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electridan.
Subcontractors: List the company name or Cty ofFt Collins license #
Electrician plumber Mechanical__ _ Roofer ��� Other
I hereby acknowledge that I have read this application and state that the a information is complete and correct. I agree to
comply with all requirements contained herein and city ordinances an a laws �yulating building construction. I know that a
permit is not valid until it has been paid and Issued. Ar
Pp Aye a� J,
Print Name: tL MfCal Slgnatur �Date