HomeMy WebLinkAbout2813 Brookwood Dr - Applications/Reroof - 08/06/2014Aug. 6. 2014 2:OOPM Roof Works, LLC No, 1050 P. 2/2
Fart of
Planning, Development & Transportation
281 N. College Ave P.O. 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). Cl 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� Date 08/06/2014
. For office use only
lob Site Address (required)
Value of Construction (labor, materials, profit)
2813 Brookwood Ft. Collins, CO
7 Jam• 6V
Property Owner Name Address
City/State Zip
Phone
Tom Stg§hvn Z813 Brootwood
Ft. Collins CO 80525
970-225-6965
Applicant Name Address
City/State Zip
Phone
Contractor Address
City/State ZIP
Phone
Roof Worx, LLC 12301 N Grant St., Ste 130
Thornton, CO 80241
303-353-1825
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
IR Here El Report
sales tax number Isrequlredbyall contractors
Are you paying with your trust account?
❑ Yes W No
50640
Is this a residential or commercial project? M Residential ❑ Commercial
If residential, is it: 54 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? M Yes IN No If yes, you mayneed to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
If pHor to 1975, you will need an asbestos assessment to submit with this application.
Des cription of work Remove PArting shingi a and replace wafh 25 sq of GAE Timberline HD
*If lawn sprinkler/backflow preveoter, must list licensed plumber. IF Flrst-Ume A/C, must list licensed electrician.
Subcontractors-. List the companyname orCRy of Ft Collins license ff
Electrician Plumber Mechanical Roofer R-21firi 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:
Print Name: Edward L Thomas Signature Date 08/0610