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Home My WebLink About5006 Snow Mesa Dr - Applications/Reroof - 07/23/2014Jul 2414 06:47a . Westers Roofing Fort Collins 9705688448 p.6 Planning; Development 8r 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) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log ❑ Heating Unit ❑ Lawn Sprinkler [3 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. Application # 1314 C 43 Date 7- 2 3-1 y rorofte use only Job Site Address (required) Value of Construction (labor, materials, profit) S-0 6 (o sncr�a t 00 Property Owner Name Address City/State Zip Phone .J Address City/State Zip Phone 9 0—(0910 g AppiicantName ��1Ec h Address City/state Zip Phone lContractmw Contractor City of R. Colii 5 S Tax # Are you paying with your trust account? T1+Yes ❑ No Wes taxnumberisrequlradbYa/icofnractorx foe Is this a residential or commercial project? )d Residential ❑ Commercial If residential, is It: 2! Single Family Detached ❑ Condo/townhome (single family attached) 0 Duplex ❑ Multifamily (apartment) ❑ Garage If commerdal, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑Office ❑Retail ❑ Restaurant ❑ Other (explain) Is this building So years of age or more? El Yes 9lo If yes, you may need lv contact Historic PreserVati°n If this is for a demolition m neyars�building a fprior to 1975, youK1�at aubmliWkh i� pp/Icabba Description of work *If lawn sprinlder/bacldiow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician. SIi0^'j G Subcontractors: List the company name or Clty of Ft Col"ns license # Bectridan 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. ApplRcant: 31D �ti . WAS S{gnatu 7� 1 Print Name: