HomeMy WebLinkAbout1800 Antero Ct - Applications/Reroof - 07/29/2014Fort Collins
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). ❑ Air Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement X3 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 #bF40'4-1 b Q Date 7/ d 9.114
For office use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
o ELCallinSpCo
605AS
Property Owner Name Address
City/State Zip Phone
9 0 /
Applicant Name Address
City/State Zip Phone
Contractor Address
City/State Zip Phone
CAPITOL ROOFING INC. 6540 S. COLLEGE
FORT COLLINS 80526 970-223-5600
Contractor City of Ft. Collins Sales Tax #
Sales tax number is required by all contractors.
Are you paying taxes here or by report? 'Here ❑ Report
Are you paying with your trust account? ❑ Yes ONO
OOo6/aofo
Is this a residential or commercial project? OResidential ❑ Commercial
If residential, is it: JXSingle Family Detached ❑ Condo/townhome (single family attached)
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office
❑ Duplex
❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes Z No If yes, 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 tWASkra
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*If lawn sprinkler/backfiow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or City of Ft Collins' license # AlJi'i roiGDa�'ti�
ex-7.B R
Electrician Plumber Mechanical Roofer_ 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: CAPITOL ROOFING INC. Signature Date
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