Loading...
HomeMy WebLinkAbout2943 Sagebrush Dr - Applications/Reroof - 08/12/2013Planning, bevelopment & Transportation n of 281 N. College Ave P.O. Box 580 r F Cdhns Fort Collins, CO 80524 � 1 Phone 97"1&2740 Fax 22,"lM • 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 nonstructural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log M Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement XRoofing ❑ Sewer Line ❑ Photo -voltaic ❑ Ventilation ❑ Water Heater ❑ Water Line b Wood/Pallet Stove (must be EPA certified, provide make, model and manufacturer). IL Complete all applicable Information an the application. Incomplete applications will not be accepted. I�z3 Application # 65Q41,76 Date gLla ? ((i for ohicr use only Sob Site Address (required) // Value of Construedon (labor, materials, profit) 27V3 0d, 00 Property Owner Name Address City/State Zip Phone D Applicant Name Address City/State Zip Phone Conttt,'aCtO Address Kai- D ru coon c� 'wo Finaj" City/State Zip Phone ' D AAr e o 800 ( 43- 6 8-03Qo Contractor City of FL Collins Sales Tax # Are you paying taxes here or by report? )isC.Here ❑ Report sar�tax nunter�srt�ulradaya#contradom Are you paying with your trust account? ❑ Yes ❑ No ie•- o'l I'l6 Is this a residential or commercial project? ;ElResidential ❑ Commercial If residential, is it: ;Ingle Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex ❑ Multifamily (aparbnent) ❑ Garage If commercial, is it: ❑ Bank C] Bar ❑ Church © Hotel/Motel 0 Medical office ❑ Office ❑ Retail ❑ Restaurant ❑ Other (explai ) Is this building 50 years of age or more? © Yes Pllo If yes, you may need to contact Historic Preservadon If this is for a demolition permit, what year was the bullding constructed? Ypnor to 1975, you will need an asbestos assessment to submit with this application. Description of work *If lawn sprinkler/bacldiow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician. Subcontractors: List the company name or Lily of Ft Collins license # Electric" Plumber MechanI al Roofer. 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. Applkant: o,pt & , signatuwe Point Name: W TO/TO 39VJ 9NI300a GNOWVIG G3d Date _8J L90bb8ZE0E ST:TZ ETOZ/1T/80