HomeMy WebLinkAbout3018 Carrington Cir - Applications/Reroof - 08/11/2014Aug 11 1412:33p
p.12
FCiof
lirt Collins
planning, Development & Transportation
281 N. College Ave P.O. Sox 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) 13 Gas Lighter ❑ Gas Log
❑ Heating Unit O Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing O Sewer Line 17 Photo -voltaic
17 Ventilation ❑ Water Heater n Water Line 13 Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable information on the application. Incomplete applications willnotnot be accepted.
Application # 6`"f DJ �" I Date & � il�1 V4
For ofFiae use only
Job S*e Address &Wvzred)
Value of Construction (labor, materials, profit)
I CLT-fi to -jty, C ►r
Property Owner Name
Address
WSt'late Zip
Phone
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, ��
Applicant Name
Address
GtyJStabe Zip
Phone
Contractor
Address
City/Slate Zip
Phone
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Contractor City City of Ft Collins Sates Taos ;t
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Are you paying taxes here or by report? ❑ Here
❑ Report
saresra� rwrnearsrawaed6ran
Are you paying with your trust account? `des
❑ No
Is this a residential or mercial project? Residential ❑ Commercial
If residential, is it: Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
Multifamily (apartment) ❑ Garage
If commercial, is It: ❑ Bank ❑ Bar ❑ Church ❑ HoteUMotel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (ex In
Is this building 50 years of age or more? ❑ Yes o IfM you may need to =tar'tHkiWw PARervadbn
If this is for a denholitlon permit, what year was building constructed?
IfpriorW 1975, ycw wA/ need an aafiestas asse£vner►t to wbin t wa this applicab`on.
of work
*If lawn sprinkler/bacMAvv prevenber, must list licensed plumber. If first-time AIC, must Ifst licensed electrician.
Subcontractors: Ltsf the company name or Crty of At Collins hbwrse #
Eiedrtdan Plumber Mechanical Roofer other
I hereby acknowledge that I have read this appitcirtion and state that the above information is complete and correct I agree to
comply with all requirements cor►tained herein and dtyordinances and state laws regulating building corWudtlon. I know that a
permit is not valid until It has been paid and Issued. I
i
Applicant: ,` ? jf t%l
print Name• / Signs
gate
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