HomeMy WebLinkAbout4107 Sherman Ct - Applications/Reroof - 06/05/2012 (2)Jun. 5- 2012 4:17PM ADVANCED ROOFING No•4516 P. 1/1
City Of Planning, Development & Transpormuon
281 N. College Ave PA. Box 580
Fort Collins Fort ins, CO 80524
Phone 970-416-2740 =i:x -424-6134
OVER-THE-COUNTER PERMITS ONLY
This application is to be used to apply for the following permits only (check all that apply). ❑ Air Condftioning
G Demolition (inferior nor. -structural) F Electrical Alteration (not service change) ❑ Gas Lighter � Gas Log
'� q 1 1 F.' a r I, i Sewer r1 Ph
Heating Unit C.' Lawn prnkler ❑ Mobile Home r_piacem:,e.:t RGonng .0 5 we. Line r oto-,oltaic
❑ Ventilation r, Water Heater ❑ WF-ter Line 0 Wcod/Pellet Stove (must be 5°A certified, Lrovide hake, model and
mamr,acturar).
Compiete all applicable information on the applicaticn. lncrmplete appiiiic�ations wili nct be accepted.
Application Y (V6j�1 ,03NO Date
For 0155ce use arty
Job Site Address �.r�y.�..i%C 'f
value eT Can.strq'sl&•jor'
(IGhOr, matanais, rrvlll)
1-fin rirn
�
Pro.pert' Owner Name
Address City/State 710
Phone 7(j
I
+ (7+ NLI a S$D
5 o (06
Name
Address cty/sate Zip.
Phone q7b
O.piicant
WG) h&-%ir0p2leS
44W& &r,+3 ,r UnC, Wincsor (20 N)S5Q.
contractor Uc #
Address Ctyllsl to ' Zip
Phone
R -j
12)P�M2.
Contractor City 01 rt. Collins Sales Tax
4t Are you raying t2xes here or by repo? ❑ Here
C Report
52/e9 taxnumG=r5y&aZrraC!ors.
Are you paying with your i; u5: account? ,kYes
❑ No
�tO5%n
Is this a residential or conmerdal project? X Rpside Dual 11 Commercial
If ra5identtal- is lt: "' Single Far-,Oy DeL-G'ted" ' Q =,nele' ,`arnil' aced II Duplex
❑ Mult'family. (aparnent) 0 Garage
Ira" commercial, is it: ❑ Bank ❑ Bar 0 Church ❑ Hc0,aVMctel ❑ MediC?I c{iice ❑ Orica 11 Retail
G Restaurant Q Other (ex, (ain)
Is this building 50 years of age or more? Cl Yes �^ o if yes, ycu rr,ayneeo'Yo coma.` n'i_�ioric Presser✓anion
If this is for a demolition permit, what year was the building constructed?
1,`pricr to 1975, you will neeJ an as�esres assessl,,7 rt to submit with this applicaVoln.
of
*17 lawn pr3venier, mum 4t licensed plum-er. If Fmss:-Urne A/C, (ills IISZ llcans8. elerridan. -
S u bgontracter5c �.e< G-�E COrjcri y rcrE Gr CIC� Gf r� CGIifr7S �lCcrS2
Z!e�-,lC!dn iturC2r M•c`2„J'C2i RCCf�r �1 Cthcr
i hereby ad4nowiecO that 1 have iced this 2GCUCaton and state t' at the above infon-nation on is corpiete and Cofrer. 1 agree to
conply w%1.all raquiremer-t: CCn� ink herein a-.d dry ordinances and state lav,5 re ul?Gng blaidino :unSt uction. I know that a
permit is not valid until it has been paid and iSSU.,J
Applicant!
r Sign
Print NameLire it Date
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