HomeMy WebLinkAbout2200 Timber Creek Dr - Applications/Reroof - 08/06/2014Aug. 6. 2014 6:54PM ADVANCED ROOFING No,7450 P. 1/1
City o{ Planning, Development & Transportation
F6} j ( r 281 N. College Ave P.O. Box 580
rL CQ4kins Fort Collins, CO 80524
Phone 970-416-2740 Fax 224^6134
OVER-THE-COUNTER PERMITS ONLY
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This application is to be used to apply for the following permits only (check all that apply). ' Air Conditioning
❑ Demolition (interior non-structural) M Electrical Alteration (not service change) L'Ge,R i:ighter .0 Gas frog
I✓ Heating Unit C3 Lawn Sprinkler Q Mobile Home repiacement '�Aflooring 0 Sewer Line ❑ Phpto-voltaic
❑ Ventilation ❑ Water. Heater ❑ Water Line 0 Wood/Pellet Stove (must be EPA. certified, provide make; model and
manu;acturer),
Complete ail applicable informaticin on the application. Incomplete applicatio wiii not be accepted.
Application e)l405�0 12 Data -
For of59ce use only
Job Site Addree3 (r qqulred)
Value of Cor+strvcdam. (labor, materials,
profit)
Property. Owner Name Address Gty/5 ate Zip &tom
Phone 30 3
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S96
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G
Applicant Name Address ty/State ZJp.
Phone �(7(j
42�W-5D l0n0• ks 9t/qb P0n4-3 Dr M1 C, Oti-dsov-. C0 8DS
boo z_�D3
Contractor Lic # Address Gty!State zip
Phone
Contractor City of Ft Collins Sales Tax r Are you paying taxes here or by report? O Here
o Repert
`elss1xnernbWSfaquirerbysOmnbocbr, Are you paying with your t-LRst account? Yes
❑ No
is this a re_sidentlal or commentai project? MResldendal ❑ commerdal
IF'rgsidental is it . ,4•mgle FamilyDeMched.' l3"Cdhdb)-loft *bike (SertliEai. liy aL uplex
❑ Multfamily (apartment) 0 Garage
If coamrnerciai, is it: ❑ Bank ❑ Bar ❑ Church O Hotel!Motnl ❑ Medicai of ice 0' Office ❑ Retail
❑ Restaurant ❑ Mher (explain)
Is this building So years of age or more? 0 Yes , o . if yam, you mayneecfto contact f;lstorrc Prae&Wl7on
If thus Is For a demcfitloO permit, what year was the building cons`tnucted?
ifPdor to 1975, you w111 need an asbestos assessriEnt to submit wi65 b5is appllced'on.
of
*if Lawn sprH. der/bacici!lew priventer, must list ficansed plumber. If first•dme A/C, must fist licensed electrician.
Subcontractors: LJsi the company name or City of Ft Co111ns license m
cllecti'd^ plumber MJ!6 nical
Room Amer ._
1-hereby ad<nowledge that I have read this application and state that Ghe above Irn'Omaton Is complete and corn t. i agree to
comply Mth. ell requirements contalned herein and city ordinances and state laws rr ulatng building con&uction. I know that a
permit is not valid until it has been paid and Issues
Applicant: n
Print Name• ____ r Sign Pure �i� Date, `�