HomeMy WebLinkAbout4156 Sumter Sq - Applications/Reroof - 08/22/2014AUG-21-2014 13:37 FROM:CEDAR CREST ROOFING 970 669 6152 TO:2246134
P.3/4
Planing, DwAgopment & Tmnspoitatlon
281 N. College Ave P.O. Box Sao
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224.6134
OVER-THEWCOUNTER PERMITS ONLY
This appllaalion is to be used to apply for the following permits only (check all that apply). 0 Air Conditioning
O Demolition (Interior non-structural) 0 Elec#W Alteration (not service change) Cl Gas Lighter 0 Gas Log
O Heating Unit O Lawn Sprinkler 0 Mobile Home replacement 8 Roofing 0 Sewer Line 0 Photovoltaic
O Ventilation 0 Water Heater 0 Water Line 0 WoodVellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applic" information on the "Wicatlon.
Application # 31Yo 6.17 L1(
For OfikeL"0*
kwomplate applications will not be sampted.
NO- -07EL/I
lob site Addre w ( - Val.re of Consbvctlon (labor, mabartals, profit)
Property Owner Name Address
City/State Zip
Phone
PA r y
)P� a
Applicant Name Address
City/State Zip
Phone
D vio P A r c s
u -I
M
Contractor LiC # Address
City/State Zip
Phone
C00.494 �. "1- -��.% � I'll a
la
4 a �. �. /
Contractor City of Pt. Collins Sales Tax #
Are you paying Coxes here or by report?
® here 0 Report
.Sates awnweerlrregrdredbyayosr&MI& s
6-1
Are you paying with your V= account?
0 Yes 0 No
Is this a residential or Commercial project? 0 Residential 0 Commercial
If residential, Is it: ® Single Family Detached 0 Condo/oownhome (single family attached) O Duplex
• 0 Multifamily (apartment) 0 Garage
If Commercial, Is It: 0 Bank 0 Bar Cl Church (3 Hotel/Motel 17 Medical office 0 Office O Retail
0 Resburant l7 Other (explain)
IB this building So years of ace or more? O Yes B No ff yes, you may need to c>7 h& hGP W* PresErvaotvr
If this Is for a demolition pannit, what year was the building constructed?
NOW to Im" )tw *ff treed an amdesow a rtto Ron& wAhh obit arppll®N=
*V lawn sPrinft/baddlow preventer, must bt 6eense 1 dumber. V f►rsHme A/C, must list 1 electrician.
Subewbucimm list ohs avmafry name or [pity of cmw Il ww o GA.44&
Sech don. pumber. Naderr®i Rodbr RgaFiAPC Otlwr
I hereby admovvtedge that I have read this applimlion And state that the above Information is complete and correct. I agree do
Comply with all requlrernents Contained herein and city ordinances and state laws regulating building Consh talon. I know that a
pm* la not valid until It has been paid and Mmled.