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HomeMy WebLinkAbout7513 Blue Water Ct - Applications/Reroof - 03/30/201203/30/2012 12:56 9705930124 GOLD ROOFING INC PAGE 01/01 Planning, Devicelopment & Transportation City{eF `` 281 N. College P1ve P.O. Box 580 F6r 1. Collins Fort Collins, CO 8D514 Phone 970416-:2740 Fax n+6134 OVER-THE-COUNTER PERMITS ONLY This application is to be used to apply for the following permits only (check all that apply). O Air Conditioning O Demolition (interior non-structural) O Electrical Alteration (not service change) ❑ Gas Lighter ❑ Qas Log ❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Homd replacement O Rooting ❑ Sewer Line .13 Photo -voltaic ❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/pellet Stove (must be EPIA certified, provide make, model and manufacturer). Complete all applicable information on the application. Incomplete applicatiions will not be accepted. Application # B)201 (PL10 "Date 3 1 For office use only Sob Site Address (required) 5�- Value of Construction (labor, materials, profit) 7S13 631k0. U.GL'e' C} CO/0 U5?-;$ (a6 S Is this a residentidvr commercial project? 11 Residengal ❑ Commercial If residential, is It: ` M Single Family Detached ❑ Condoltownhome (single famlyr attached) . ❑ Duplex ❑ Multifamily (apartment) 0 Garage If commercial, is it M Bank ❑ Bar ❑ Church ❑ Hotel/Motel © Medical office ❑ Office ❑ Retail 0 Restaurant ❑ Other (a plain) Is this building 5o years or age or more? ❑ Yes VINO Ify�s, yvu mayneed to .mn HlStorlc P er►2G'an If this is for a demolition permit, what year was the building constructed? ffprlor to 19;3i you will need an asbes=assessmP✓rt to submit WIM this app/iratbn.. Description of work *If fawn skier/bacidiow premier, must list licensed plumber. If first-time A/C, must list licensed electrician. Subcontractors: List tfie company name or ofIt070Kflmw a" e Numter. 7Nedlanical • R043 Other I hereby acknowledge that I have read tltis appluitign and state that the above informatio n is complete and cDr ecL I agree to comply With all requirements contained herein and city ordinances arid state laws regulatin g bufldmg construction. I know that a permit is not valid until 'rC has been paid and housed. Applicants Print Named—�R (III ��CnY Gila Signature Data