HomeMy WebLinkAbout3213 Killdeer Dr - Applications/Reroof - 04/10/2012APr,10. 2012 10:04AM Bob Behrends Roofing
N o , 6 8 9 9 P- 2
-(Zky of
Planning, Development & Transportation
281 N. College Ave P.O. -Box
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
OVER-THE-COUNTER ER PERMITS ONLY
This application is to be usedto'apply for the following permits only (check all that apply). ❑ Air Conditioning
❑ Demolition (interior non-strtatural) ❑ Electrical Alteration (not service change) O Gas Lighter 0 Gas Log
❑ Heating Unit Cl Lawn SprWer. ❑ Mobile Home replacement )(Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water beater ❑ Water Line ❑ Wood/Pellet,Stove`(rnust be EPA certified, provide make, model and
manufacturer).
Complete all applicable information on the application.
Application # . q i q
For office rese v*
Incomplete applications will not be accepted.
Date _ \\oX\
IJob Site Address (regtd`d) I Value of Construction (labor, .materials, profit) i
Is this a residential or commen:%Lproject? IN Residential ❑ Commercial
If residential, is it: 0 Single family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ MuNzally (apartment) ❑ Garage . .
If commercial, is it: ❑ Bank 938ar ❑ Church ❑ Hotel/Motel Q Medical office ❑ Office ❑ Retail
❑ Restautat • ❑ other (explain)
Is this building 50 years of ageor more? ❑ Yes XWo Ifyes, you may need to contact HistoricPreservation
If this is for a demolition perk. what year was the building constructed?
Ifpr/or to 1975, you will need asasbestos assessment to submit with this app/halloo.
Description of
*If lawn spdnkler/baddiow preve&r, must list licensed plumber. If first-time A/ , must list licensed electrician.
Subcontractors: L/st the carrap®ay;+ame or City o(ft Collins license 9
Electrician PluraW Mechanical Roofer - \\- \ n � Other
I hereby acknowledge that I havemad this application and state that the above information is complete and correct I agree to
comply with all requirements coruned herein and cb/ ordinances and state laws regulatind building construction. I know that a
permit is not valid until it hasbeen paid and issued.
Applicant: ,\��
Print Name: V `,b z c�c 2-, Signature
pate