HomeMy WebLinkAbout1625 Redberry Ct - Applications/Reroof - 08/15/2014Planning, Development & Transportation
city,f 281CO���nS For N. College Ave P.O. Banc 580
Fort .7 Collins, 00 80524
Phone 970-416-2740 Fax 224- LM 3S , 1�0
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) 0 Gas Lighter ❑ Gas Log
Heating Unit 0 Lawn Sprinkler ❑ Mobile Home replacement G Roofing ❑ Sewer Line ❑ Photovoltaic
❑ 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 # )JLJ � �� Date
Fa olae use only
lob Site Address (required)
2S RIM � e Iz c'c. --
Value of Con (labor, materials, profit)
2.S sm �`2�(70
Property Owner Name Address
City/state
Zip
Phone 7tID
S t(qZ �-� c
. Cok
3os2�
Q��-� n l
Applicant Name Address
4£e'� Six 40 }F�w�►��gt>ha, •D►•
City/State
( r sok. (o.
Zip
som
Phone
4-10-65S -OS R
Contractor Address
�� �' E iZooic �Kc. Sit J acts gam IYN I
CRy/State
Zip
Phone
vs -05ect
Contractor City of Ft Collins Sales Tax #
Sorg byas Are you paying with your trust account?
P(Yes ❑ No
S26gL
Is this a residential or commercial project? f lAesidentlal ❑ Commercial
If residential, is it 19 Single Family Detached ❑ Condo/towntome (single family attached) ❑ Duplex
13 Multifamily (apartment) ❑ Garage
If commercial, Is It: O Bank 17 Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant 0 Other (explain)
Is this building 60 years of age or more? 13Yes g No If yt s, yrw may need to cant Htsh'mk Pnehervatlon
If this Is for a demolitlon permit, what year was the building constructed?
'D°prlar to 1975. yhw will need an a0estas assessment to 94ve WM this appllcatlari.
Of
*If lawn sprinlder/badQiow preventer, must list Ikhensed plumber. If first-time'A/C, must list licensed electrician.
subcontractors: Ust tine company name or Oty of R Co Nns Ncww #
Beaddan. Plumber Medhanke Roofer -R� 23 3 / Other
I hereby adowwledge that I have read this application and state that the above Information Is complete and correct. I agree tD
comply with all requirements contalned herein and dty ordinances and state laws regulating building corstvctIOn. I know tlnat a
Pa.. Is notvaiki untilIt has been paid and blued.
PrI nw
PrinnP6K Sarah maturet Name:
Datie 3- k5- (I