HomeMy WebLinkAbout2507 Ridge Creek Rd - Applications/Reroof - 08/19/201408-18-'14 16:13 FROM -Premier Hoofing
Fort Collins
9704848308 T-204 P0003/0003 F-420
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CD 80524
Phone 970-416-2740 Fax 224-6134
OVER-TH&COUNTER PERMITS ONLY
This application is to be used to apply for the following permits only (check all that apply). ❑ Air Conditioning
Q Demolition (Interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler 13 Mobile Home replacement ❑ Roofing ❑ 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.
ApplicaR #i n
3 Date — (9 -'
�f
6
c
Job Site Address (required)
Value of Construction (labor, materials, profit�aU
Property Owner Nani
Address City/State Zip
Phone
Applicant Name
Address City/State Zip
Phone
tractor
( ex Rcofi no
Address City/State Zip
0lEK e
Phone
Contractor City of Ft. Collins Sales T
May tarnumberIsMqu#edbya#MnkadM
# Are you paying W&es here or by report? ere
Are you paying with your trust account? ❑ Yes
❑ Report
❑ No
Is this a residential or comm�eercial project? L9'Residentlal ❑Commercial
If residential, is it. @Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
O Multifamily (apartment) ❑ Garage �1
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑Vlaln
tel ❑ Medical office 0 Office i7 Retail l�
❑ Restaurant ❑ Otter (exIs this building 50 years of age or more? ❑ Yes04 )nu may need to contoctH/sfivt Pres&wNon
If this is for a demolition permit, what year was the building constructed?
Kptlor to 197Z you w/// need an asbeslas assesmwt to submit with this applicatim.
lawn sp¢nkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractor$: Wthe comrpanymmeoralyofRcolNnsActt"M0
Electridan Plumber Mechanical :koofer 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.
Part /
Name: J signature� �� Dais