HomeMy WebLinkAbout1627 Foxbrook Ln - Applications/Reroof - 03/14/2012From Affordable Roofing Inc 1.970.207.0289 Fri Apr 20 12:02:54 2012 MST Page 1 of 1
Piaruung, Development & Transportation
rty f 281 N. College Ave P.O. Bat 590
&t G",F - Rim s FortCollins, M 80524
Phone 970-416 2740 Fax 224.6134
r.ost-
OVER-THE-COUNTER PERMITS ONLY
This application Is to be used to apply for the following permits only (check all thatapply). O AIr CondiBoming
O Demoillon (interior non-structural) O Ele,^,hical Aitarabon (not service cRanoa) ❑ Gae Ligfiter Gas Lag
p Heating Unit 0 Lawn Sprinkler O N,obile Home replacement D Roofing O Savrer Line ❑ Pha'o-voltsic
O Ventilation O itlfatar Heater O Water Line O WoodlPeitet Stove (must be EPA certified, Provide make, model and
nanufacturer). •
Complete all all le krfonnation on the application. Incomplete applicationswlll not be accepted.
Application ;�_ O Date
.raw „m nnry
Job site Address Crw whe,02
Value of Construction (Faber, rrabriaks, PrOW
�' 7 z>•� t,b`(�
FTC C�
S�Z-S _:� ���
;Property Owner Name
_
Address
atYlstate Zip Phone O
` U
2�6Z-26ea
cant Name
Address
-^
W/StaterFt,(0,i,Zip 5 Phone
5 a
2
;Contract r
Addressmy/state
Zip Phone
a
`Contadnr aty of i2 Collins sales
Areyou. paying taxes here or by repor? � Here O Report
❑ NO
i�SrlartarnumwrlsreT�bya.7cc, Etudes.
Are you paying with your trust accuimt7 Es
!is th5 a residential or mmmercial project?-*eswentw ❑ Commercial
';if residential, is it ngle Fsmliy Detached Cl Condo/townhmie (single famliy sibdtad) DUPk-x
Multifamily warmient) ❑ Garage
;If cornmerdal, is it: ❑ Bank a Bar Q Church C3 Hate(/h;ntel ❑ Med'ical office ❑ O,'�ce ❑ r�fi
0 Restaurant ❑ Other (explain)
is this building so years of age or more? Cl Yes �$'flb Ifyes, yoc� trray need'v7 ¢vrrnctH/skrcPt �enmtlon
`If this is for a demolition permit. what year was'tme building CW-V&JCted7 - •-
„IfRitr to 1375, you wJft need an asbestos assamwEnt to subnuTWJM tiers applrWtw-
oP work
*Jf Sawn sprinlderlbacidow preventer, must lLR lk2nsed plumper. If tlrsrthrn AJc� must,ri4 kensed electrician.
i.SWsrnntrectorsi Itst the rnmpsnJ' name ord3' olFt cNDnslt[ense ar
pynbe, o-techaniraL R00W OJrer
6ectirtyr.
.I hereby admasvledga that I have read this appliu�tlon and state that the abovekffarmaWnIs=Pkleando�rrect ragreem
. mmD1Y Nita ai( requirements mntamed beraln and dry ordinances anal state law9 regulating building C`"Skn [Gan. I krmw that a
permit is not valid unto it has been paid acid lsauea r
is -
',APPJrni'Itame: �rtY11l( ''Ur"•;k1 SigtiaterA 7, 1 (�•. -Date L' Z.
O` •