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HomeMy WebLinkAbout4236 Cape Cod Cir - Applications/Reroof - 07/03/2014of F ft matins OVER - Planning, DevekWnmt & Transportatlon 281 N. College Ave P.O. Box 580 Fort Collins, 00 NS24 Phone 97"16.2740 Fax 224.6134 PERMITS ONLY This application is to be used to apply for the fpllowing pen» ite only (check all that apply). ❑ Air Conditioning ❑ Demolition (interior non-s#ructural) 0 Electrical 'A, iteration (not service change) Ci Gas Lighter Q Gas Log ❑ Heating Unit © Lawn Sprinkler Q Mobile Homes replacement IX Roofing ❑ Sewer Line ❑ Photo -voltaic ❑ Ventilation O Water Heater ❑ Water tine 0 Wood/Pellet Stove (must be SPA certified, provide make, model and manufacturer). Complete all applicable information on the application. Incomplete applications will not be accepted, Application #_ _f,51403g06 Hate �%� 3--1 Aorofte use only ]ob Site Address 6rmiaw Value of Canshyrcl:lor► (labor, materials, profit) Property Owner dame Address to ' . Zip Phone INA� �'1Vt�g Applicant Name Address City/State Zip Phone i Contractor Address City/State ZIP Phone f�1 iFs7tc t� WOO 8O538 -4I li Contractor City of FL Collins Sales Tax # ! Are you paying taxes here or by report? 0 Here ❑ Report Saks tax numberareqwnd by all canbaaurs Are you paying with your trust account? IN Yes ❑ No yS8�9 Is this a residential or commercial project? 6 Residential ❑ Commerdal If residential, is it: 0 Single Family DeuK hed b Con&/townhome (single family attached) C] Duplex ❑ Multifamily (aparbrient) R Garage If commercial, is itr ❑ Bank O Bar ❑ Church Nobel/Motel ❑ Medical office ❑ Office ❑ Retall 0 Restaurant 0 other'( n) is mis outaing au years or age or moree u Yes No !t ye&youmayneW to conW H,t WlfcPnNw*t/on If this is for a demolition permit, what year was building cortstructed7 Ifpriorto 1975, you W//17eEdan asbeslosasltbmltNdfi WSap(Adkwam Description of Work *If lawn sprinlder/baddlow preventer, must fist licensed Subcontractors: Lk-r the almpanyname or OW offt < ftffldan If first-time NC, must list licensed electrician. ician. ri'M AXYMB . Medunial 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 end city oidmances and state laws regulating building eonstrvctlon. I know that a permit is not valid until it has been paid and issuedAppli. Print N rrC �} 6� W_ ` d-rme.S Slgnawrls ' Cara / -16" Print Name:_i'ti (vP}