HomeMy WebLinkAbout901 Battsford Cir - Applications/Reroof - 06/11/2012Ave
"Gity} of Planning, ifevelopment &T'renspoitation
281 N. Col■ of ` oLLIns Fort Collinsl, CO 80524 P.O. Box 580
Phone 970-416-2740 Fax 224-6134
OVER"TWE-COUNTER PERMITS ONLY
This appiicatiois 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 O Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement RRoofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation CWater Heater ❑ Water Line ❑ Wood/Pellet Stave (must be EPA certified, provide make, model and
manufacturer).
complete all allplicablIF information on the application. Incomplete applications will not be acce ted.
Application # Date
ofte use only
Job Site Add (requin5V2 Value of Construction (labor, materials, profit)
Property Owner
IName
Address
City/State Zip
Phone
Y
Name
Address
city/state zip
Phone
11cant
J
CA
r
Conoctor
LIC #
Address
City/State Zip
Phone
1Aff A6tj
b:f��-/
/%irl)
Contractor City
f Ft. Collins Sales Tax #
Are you paying taxes here or by report? 'Here
❑ Report
sales tax number Is
&Iaff avtoidom
Are you paying with your trust account? ❑ Yes
❑ No
Is this a redden I or commercial project? ❑ Residential ❑ Commercial
If residential, is : RrSingle Family Detached ❑ Condo/townhome (single family attached)
❑ Multl%mily (apartment) 0 Garage
If commercial, Is t: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel O Medical office ❑ Office
Is this building ;
If this is for a dh
Irpnior to 1975,
Description of
*If lawn
I hereby admo
comply with all
permit Is not
O Duplex
❑ Retail
0 Restaurant ❑ Other (explain)
years of age or more? O Yes O No ff yes, you may need to contact H/storic Preso mtfon
w0tion permit, what year was the building constructed?
w w111 need an arbe fos a inent to submit w/tfr"ap#1 adon.
backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
[mot life company name or City of Ft CoHns Ikewe if
Plumber Mechanical Roofer c-2L rJOther
that I have read this application and state that the above Information Is complete and correct I agree to
ements contained herein and city ordinances and state laws regulating building construction. I know that a
unfit It has bean paid and Issued. A