HomeMy WebLinkAbout3127 Yellowstone Cir - Applications/Reroof - 08/11/2014From: Katrina Fenzi Fax: (970) 672-0486 To: +19702246134 Fax: +19702246134 Page 4 of 7 08/1112014 2:69
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281 N. College Ave P.O. Box 580
Fort C.61tin's Fort Collins, CO 80524
Phone 970-416-2740 Fax 22+6134 Al&n'18
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) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ 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.
Application #�"I �s I ✓ Date
For o>irce use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
3127 Yellowstone Circle
33 squares
Property Owner Name Address
City/State Zip
Phone
David Greenhouse 2348 S Yukon Ct.
Lakewood/CO 80227
303-884-5056
Applicant Name Address
City/State Zip
Phone
Denali Roofing, LLC 2310 E 13th St.
Loveland, CO 80537
970-660-4417
Contractor Address
City/State Zip
Phone
Denali Roofing, LLC 2310 E 13th St.
Loveland, CO 80537
970-660-4417
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
SI Here ❑ Report
Sales tax number is required by allcontrwWs
Are you paying with your trust account?
❑Yes Is&]No
49209
Is this a residential or commercial project? 13 Residential ❑ Commercial
If residential, is it: ® Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes m No Ifyes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed? _
If prior to 1975, you will need an asbestos assessment to submit with this application.
Description of work tear off shingles down to deck, install ice and water and drip edges at eaves.
install GAF 130 mph rated duration Tru Def shingles
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or City of R Collins license #
Electrician Plumber Mechanical Roofer R2111+ 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.
Applicant: az ,a Q,t -
Print Name: Katrina Fenzi Signature D Date