HomeMy WebLinkAbout4506 Seaway Cir - Applications/Reroof - 08/25/2014FROM :kessier FAX NO. :
Aug.25 2014 09:11AM P2
ort Collins
too
Planning, Development & Transpw1adan
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone'970-416-2740 Fax 224-6134
OVER-THEwCOUNTER PERMITS ONLY
This application is to ba usad to apply for the following permits only (check all that apply). Ci Air Conditioning
Cl Demolition (Intsrior non-structural) 0 Electrical Alteration (not service change) 13 Gas Lighter 0 Gas Log
0 Heating Unit Cl Lawn Sprinkler 0 Mobile -Home replacement IKRooting 0 Sewer Line O Photawaltaic
13 Ventilation ❑ Water Heater 0 Water Line n 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 #,
for of a use only
Date��/
Job Srm Address (n:qufrr d)
Value of Construction (labor, materials, profit)
'Z32jS00
Property Owner Name Address
City/State
Zip Phone
NN t 0 50
t)a 1
Applicant Name Address
City/fie
Zip Phone
Contractor Address
City/State
.ap Phone
,,slag Ev A , aw. kw
0&c4vr (o.=car`.
Contractor City of R. Collins Sales Tax # . *3! '4P 4P 3
)<Yes 13 No
_qAw ftrawnbe•Isragrdr&byaYcwfbad=
Are you paying with your
trust account?
Is this a residential or co erdal projed? OResidential 1.3 Commercial
If residential, is It or
Family Detached 13Condq/oowntame (single family attached) 0 Duplex
❑ Multifamily (apartment) 0 Garage
V oommerdal, Is it: O Bank C] Bar 0 Church 0 Hotel/Motel ❑ Medical office D Office 13 Retail
❑ Restaurant 0 other (explain)
Is this budding 60 years of age or more? Ci Yes O No !f yess, you mayneed to ctiniaet H/sQaHc Preswva&n
If this is for a dem cdIden permit, what year was the building constructed?
Yjai `or io 1975, ym will need an asbestos assent to submit with d* apphaWaa
Dewriptlon of work
*If lawn spdnkler/baddiow preventer, must fist licensed plumber. If fwA time A/C, must IlstAMSed electrician.
subcontradarmr Lb t the company name or 07y of Ft Ca%v ficom 0
Eterki�an Plumber. MedrO deDI Roofer _ Oilier
I hereby acknowledge that l have read this application and state that the above Wormation is complete and domed`. 1 aWft to
comply with all requirements contained herein and city ordinances and state laws regulating building construction. I know that a
permit is not va0d until It has been paid and Issu9clL
print Nam