Loading...
HomeMy WebLinkAbout3028 Tulane Dr - Applications/Reroof - 07/24/2014Cit Of Planning, Development & Transportation or�t Collins Forst Colliins CO 80s24 P.O. Box 580 Phone 970-416-2740 Fax 22"iN OVER-THE-COUNTER PERMITS ONLY $1307 This application is to be used to apply for the following permits only (check all that apply). ❑ Air Conditioning ❑ Demolition (interior non-structural) 0 Electrical Alteration (not service Change) ❑ Gas Lighter ❑ Gas Log 0 Heating Unit O Lawn Sprinkler O Mobile Home replacement ❑ Roofing C3 Sewer Line ❑ Photo -voltaic 13 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 # N404456 Date For offike um only Job Site Address ( lrea) Value Of Construction (labor, materials, profit) LAO✓ v Property Owner Name Address City/State Zip Phone ems' -224� L137 Applicant Name Address City/state Zip Phone �' o�Gl/ 2oG.3 I STD Y>�li/f. Contractor Address City/State Zip Phone 9 1- a E2 9✓W 'Z.2 z Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? OpHere ❑ Report Satw & 'n~ &mquiiedbraumnbaet m 9 4 J2�3 Are you paying with your trust account? [] Yes 66 No Is this a residential or Commercial project? AlResidential ❑ Commercial If residential, is it: IPSingie Family Detached © Condo/townhome (single family attached) ❑ Duplex ❑ Multifamily (apartment) ❑ Garage if commercial, is it: ❑ Bank 0 Bar ❑ Church 17 Hotel/Motel ❑ Medical office 0 Office 0 Retail O Restaurant ❑ Other (explain) Is this building 80 years of age or more? ❑ Yes ®No 1f yes, you may need b mbtt Histmfc p me vabbn If this is for a demolition permit, what year was the building constructed? 1f pnor to 1975, yak will need an asbafts assamnent to submit wit this application. • �•1 *If fawn sprinkler/baddiow preventer, must list licensed plumber. If first-time VC, must list licensed electrician. Subcmrbactors: 4& the company name or Oty of IT Colft /bone A Plumber Me&aikat Roofer Other I hereby acknowledge that i have read this applkation and state that the above information Is complete and correct. I agree tp comply with all requirements contained herein and city ordinances and state laws regulating building oonstrucdon. I know that a permit is not valid until it has been paid and issued. Print rw tce PrirK ��os ignmyre Name: �t- S Dew