HomeMy WebLinkAbout3306 Monarch Ct - Applications/Reroof - 03/19/2012City Of Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fort Collins 3!��Fort Phone o970- 16-27llins, CO 0404 Fax 224-6134 * JD
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.
Application # R,121) 3 //:3
For office use only ---*'
Incomplete applications will not be accepted.
Date
Job Site Address (required) Value of Construction (labor, materials, profit)
33L16 /A4ayLa,rGI d- $
Property Owner Name Address
City/State Zip
Phone .
o, 3
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574-2-1
Akplgllicant Name Address
City/State Zip
Phone
&VIwe< 1
( �a 3
f7e - -9
Contr ctor Lic # Address
City/State Zip
Phone
,- / /2
Lo
455 =9
Contractor City of Ft. Collfris Sales Tax #
Are you paying taxes here or by report?
❑ Here %Deport
Sales tax number is required by a//mnbactom
Are you paying with your trust account?
❑ Yes KVo
Is this a residential or commercial project? !C Residential ❑ Commercial
If residential, is it: le Family Detached ❑ Condo/townhome (single family attached)
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office
❑ Duplex
❑ 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?
Ifprior to 1975, you will need an asbestos assessment to submit with this applicadon.
*If lawn sprinkler/backflow 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
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: Signature Date
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