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HomeMy WebLinkAbout2026 Prairie View Ct - Applications/Reroof - 04/25/2012CRYof _Fort CdUn5 Planting► Development & Transportation 281 N. College Ave P.Q. Box 580 Fort Collins, CO 80524 Phone 970-416-2740 Fax 224-6134 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 is Heating Unit 0 Lawn Sprinkler ❑ Mobile Home replacement 19 Roofing © Sewer Line ❑ Photo -voltaic ❑ Ventilation ❑ Water Heater ❑ Water Line C) Wood/Pellet Stove (must be EPA certified, provide make, model and manufacturer). Complete all applicable information on the application. Incomplete applications will not be actiD Application # N Date Por office use only Sob Site Address (mgilfia j Value of Construction (labor, materials, profit) n .2or) G Pr'cs� 'f' \) 1.� z _ 7 ro `1 _ R Property Own me Address CityState Zip go Phone ca ell j, 7jo 3&,7,R u Applicant Name Address City/State Zip Phone Contractor Address Cty/5tbte Zip Phone 1"1RT6STuG 2g�j-,J WOo ) N_ GURV,7 L UVGLI; %Zv 80S3S -tf )i Contractor Cdy of Ft Collins Sales Tax # Are you paying taxes here or by report? ® Here 13 Report Sales&xnurobm'fsreqWWbyallmnfradv'--- Are you paying with your bust account? 0 Yes ❑ No 5 I& 3cl Is this a residential or commercial project? 4 Residential ❑ Commercial If residential, is it ® Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex ❑ Multifamily (apartment) ❑ Garage If commercial, is it: ❑ Bank 0 Bar ❑ Church ❑ Hotel/Motel ❑ Medical office El office ❑ Retail 13 Restaurant O Other (explain) Is this building 50 years of age or more? ❑ Yes G No Ifyes, you mayneed to cw7tact HisiavicPreservdfian If this is for a demolition permit;, what year was the building constructed? Ifpdor'to 1975, you Will need an asbestos assessmeot A7 submit with this applicab'on. Description of work • � Q u�Qt;S *'If lawn S"Ider/badldiow preventer, must list IiCensed plumber. If first-time A/C, must list licensed electrician. Subaontmctors: List Ghe mmpany name or Lily of R CoMns lkmo i? EleCbidan pkmt r Mechanie Roofer R-15 i Q other I hereby acknowledge that I have read this application and state that the above Information is complete and caned. I agree to comply with all requiremerds contained herein and city ordinances and stave laws regulating building ounanxtion. I know that a Permit is not valid until it has been paid and Issued. Applicant Print plama•