HomeMy WebLinkAbout319 Dunne Dr - Applications/Reroof - 08/15/2014Planning, Development & Transportation
atyof qColtins 281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 97"16-2740 Fax 22"134
OVER-THE-COUNTER PERMITS ONLY & (10. -75
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 service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement )A Roofing ❑ Sewer Line ❑ Photo-voilalc
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Sto a (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable information on the application. Incomplete applications will not be accepted.
Appiicadon # LA 0b` Date
Far aww M only i c� �n a frt �eSS'
,lob Site Address (mqubed)
Value of C n
SO
on (labor, materials, profit)
20
Property Owner Name
Address
It0Lk�
City/State
Zip
Phone cM
soU'� ( �
�
CO l
Q05Z
ss� - g 7
Applicant Name
P-006:g&-r-Sf%1C6A
Address
4w AJwe+ v,%qh
Cfty/state
a sok• to,
Zip
som
Phone
qw-655-oSgi
Contractor
Address
aty/State
Zip
Phone
0-f -t 9ooFiKt,
_
%t J ♦css T1 Jw
(*SIB -oS8
Contractor City of Ft. Collins Sales Tax #
-%W am mxtw Ar bye0antladom Are you paying with your trust account?
P(Yes ❑ No
6
Is this a residential or commercial project? Residential ❑ Commercial
If residential, is it: VSingle Family Detached ❑ Condo/aownhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, Is It: O Bank ❑ Bar ❑ Church ❑ Hotel/Motel 0 Medical office ❑ Office ❑ Retell
l] Restaurant C3 Other (explain)
Is this building So years of age or more? ❑ Yes f No Ifyes, yhw may need to contact H/sWc PrvwJwtfon
V tt& is for a demolition penult, what year was the building constructed?
Fp for to 1975, you w0/ need an as6estas asaenent to submit Wffi this aAWcadan.
0
*If lawn spNnlder/baddiow preventer, must list licensed plumber. If first-tlmreWq must list licensed decbiden.
Subcontrsdaw L& Lhe a mphiny name or o y of CoRns GIcww 0
FL den Phmlber mec, Roofer _R, 23 3 Y Dow
I hereblr advhowWW that I have read this application and state that the above Inforrnation 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
Pa. it Is not valid until It has been paid and Issued.
Pm�eme: � (c 7 QX'�a h 9gnature
Date a (S — f