HomeMy WebLinkAbout3215 Grand Teton Pl - Applications/Reroof - 08/08/2014City.of Planning, Development & Transportation
281 N. Ave
FoCollins Fort Collinege s) CO 80524.0. Box SW
Phone 970-416-2740 Fax 22"134 a
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 fItoofing ❑ 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 # � J> Date &Z4z
For ofte use only —,�
Sob Site Address (required)
Value of Construction (labor, materials, profit)
3 /00
Property Owner Name
Address
City/State Zip
Phone
G a
15- -*41 AI PI-( 61471 Ze
&*v -709'3
Applitant Name
Address
City/State Zip
Phone
Contractor
Address
City/State Zip
Phone
S
s 7a 'Cee,,l
le, keS Or. 26
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
❑ Here ❑ Report
Saks tax numb rIsrequiiedbya0mntractom
Are you paying with your trust account?
❑ Yes ❑ No
Is this a residential or commercial project? P4 Residential ❑ Commercial
If residential, is it: I(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? ❑ Yes 14No If yes, you may need to contact Historic /3eservaborr
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.
i of work
b-71:nA
lawn sprinkler/backflow preventer, must list licensed plumber. 'If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or City of Pt Collins licensee #
Electrician Plumber Mechanical Roofer Other
I hereby acknowledge that I have read this application and state that the above information Is complete and coned. 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.
Print Name:grrvt J,//, llSol Signature Date