HomeMy WebLinkAbout1438 Redberry Ct - Applications/Reroof - 08/15/2014City Of Planning, Development & Transportation
Fort Collins Fort N. College Ave P.O. Box 580
t Collins, CO 80524
/14" Phone 970-416-2740 Fax 224-6134 if
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 service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement KRoofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application # B140(olb(p. Date
For ofce use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
e �
Property Owner Name Address
City/State Zip Phone
6 a P
64 9D5,ZS d- W �;4�//
Applicant Name Address
City/State Zip Phone
Contractor Address
City/State Zip Phone
o s o s me /3555
, � y�'
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report? �f Here ❑ Report
m Sales tax number is required by all n acto
36v7-R
Are you paying with your trust account? ❑ Yes R No
Is this a residential or commercial project? P Residential ❑ Commercial
If residential, is it: 45 Single Family DetaclYed ❑ Condo/townhome (single family attached) ❑ Duplex
❑ 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 ❑ No If yes, you may need to contact Historic 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 with this application.
Description of work Kew-z)&-e— 00 S/t-4 +c:) cdeo-k <,
*If lawn sprinkler/backflow'preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or City of Ft Collins license Y t t -i C A
Electrician Plumber Mechanical Roof eQon<_ 7- ra 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:
Print Name: Signature Date