HomeMy WebLinkAbout5410 Apple Dr - Applications/Reroof - 08/06/2014Aug, 2, 2014 11:08AM Roof Works, LLC
No.1,021 P. 2/3
City of
ort Coll�r�s
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524 1,10 "iS
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 ❑ Roofing ❑ Sewer Line O 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 # q-0�29 Date 08. DU - W14
For oltice use only
Job Site Address (required)
5410 Apple Drive
Value of Construction (labor, materials, profit)
22227-43
Property Owner Name Address
Randy Jones 5410 Apple Drive
Oty/State Zip
Fort Collin 970-228.4,141
Phone
Applicant Name Address
Roof W rx LLC 12301 N Grant St
City/State Zip
Ste 130Thornton, CO 80241
Phone
-1 25
Contractor Address
City/State Zip
Phone
Contractor City of Ft. Collins Sales Tax #
sAstax number isrequkedbyellwntroctwr.
50640
Are you paying taxes here or by report? ID Here
Are you paying with your trust account? ❑ Yes
❑ Report
R1 No
Is this a residential or commercial project? ® Residential ❑ Commercial
If residential, Is it: ❑ Single Family Detached ❑ Cando/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel M Medical office ❑ Office O Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes 9 No lfyes, you mayneed to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
ff prior to 1975, you will need an asbestos assessment to submit with this application.
�• • • • • �E11.• • IN •• . 1 .1 • - • _:. -1.• :• •
*If lawn sprinklerfbaddlow preventer, must list licensed plumber. If first-time AIC, must list licensed electrician.
Subcontractors: L& the companyname or City of Ft Collin license #
Electrician Plumber Mechanical Roofer B-i 1 Rr, 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.
Applicants
Print Name: Edward I Thnmas¢ Signature Date 081091201A