HomeMy WebLinkAbout1937 Jamison Dr - Applications/Reroof - 07/16/2014ToP-'- 2 -1 3 2014-07-Ie 15 a4 a 1 (GMT) laoa5SSSZ70 From. JOI n Gr-ra
City f Planning, Development & Transportation
F6r Y O281 N. College Ave P.O. Box 580
_ rt C41tin s 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 se ice change) ❑ Gas Lighter ❑ Gas Log
171 Heating Unit 177 Lawn Sprinkler Cl Mobila Homo raplaconnant Roofing rl Sawar Lino ❑ Photn_voltnin
i i ia) w ta�tu� ci )•
Application t/ 13 140H 11 �j Date
For office use oniy I I D S
Sob Site Address (required)
Construction (later, materials, profit)
Varl70,00
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P perty Owner Name Address
City/State Zip
Phone
� � 4
Ap licant Name Address
7
City/State Zip
Phone
C
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Contractor Address
City/State Zip
Phone
Contractor City of Ft. Collins Sales Tai#
Are you paying taxes here or by report? ❑ Here
❑ Report
sales tax (w r Ls required by all contracYo 5
Are you paying with your trust account? ❑ Yes
D NO
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Is this a residential or commercial project? lW, Residential ❑ Commercial
If residential, is it: XSingle Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
O Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes Aft If yes, you may need to contactHistonc Preservation
If this Is for a demolition permit, what year was the building constructed?
If prior to 1975, you will need an asbestos assessment to submit whit this application.
Description of work X& _
*If lawn sprinkler/baddlow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or G'ty of At Collins license 0
Electrician
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. /
Applicant: '<eV'9q'4
Print Name:Signature Date �� !