HomeMy WebLinkAbout2408 Orchard Pl - Applications/Reroof - 05/27/2014May•27. 2014 9:54AM ADVANCED ROOFING
No•7236 P. i
atyof Planning, Development & Transportation
j 281 N, College Ave P,O. Box 580
w(i , rl,{. Collins Fort: Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
OVER4HE-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 service change) n 1es i-ighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement Rooting ❑ sewer Line 0 P'noto-voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line l.i Wood/Pellst stove (must be EPA certified, provide make; model and
rtranufacturar). .
Complete all applicable information on the application. Incomplete applicafions will not be accepted.
Application m LW'217 -q f)
fbr afce usa only
Date -L72 -7
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Property Owner Name Address City/State Tp20-5Q)
Phone 303
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Applicant Nome Address city/Stat* ZIP.
Phone q-70
&-rA��0rnLLbilks Qggb &� Dr Un l) WS5
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Cont«ctor Lic Address Goy/site e
Phone
Pr
ContractLor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? ❑ Here
❑ Report
Sales tax numterisAre you paying wiu your test account? 'Yes
0 No
Is this a residential or commercial project? )�Rpsidentdal M Commercial
- It-residentisl,•is it'•••••' ••Single';;=smiiy'Detoched" ' [7"Co'tfdb%to+Nntib"ritz (siridle'far'�itry atELacfiiaq) " L7•P&ex
•
12 t ult `amity (apartment) 0 Garage
If commercial, is it: ❑ Bank ❑ i era' ❑ Church ❑ HamMI/Motel ❑ Medical cfc_ ❑ CTtce ❑ Remit
G RAstBurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes �!40. -Yves, you ray need'to cantB& M7151"arc Pre_Serrarion
if this is for a demolition permit, what year was the building constructed?
Tj prior to 1975, you will need an z-cbestos 2EsaEFm� snt to submit wits this arpJlcotion.
esc Ipti n of work . I - Q, �X I �' Sh ,
2 6
� SV
*If lawn spr!rj er/baccflcw pri.venter, must Est licensee plumber. if firms tme NC, must list fiber,_ad electrician,
5ubenntractors: Lst Me cn-itperyrene or City or R Collins license 0
a -scan Plumber Roofer) - - );W' 1 Other
'
Thereby acknowledoe that I have lead this application and state rhat the above information is complete and correct, i agree to
cdniply µ flth.ail require; is con(ained herein and city ercirancas and 5t to laws rerulcting building cons:: uction. 1 know that a
per It is not valid until it has been paid and issue ,
Applicant;
Print Name' Sign Wra bato