HomeMy WebLinkAbout718 Great Plains Ct - Applications/Reroof - 08/11/2014ngi
City of Plann 281 N.College Development P.O. & 5 tion
�►dfi s Fort Collins, 00 80524
Phone 970-416-2740 Fax 224-6134
OVER-TH&COUNTER PERMITS ONLY
This application Is to be used to apply for the following permits only (check all that apply). 0 Air Conditioning
❑ Demolition (interior non-structural) 0 Electrical Alteration (not service change) 0 Gas Lighter ❑ Gas Log
❑ Heating Unit 0 Lawn Sprinkler I] Mobile Home replacement t&Roofing ❑ Sewer Line 0 Photo-voihaic
O 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.
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Date - « - 2(Dkq
/_ o T
Jlob Site Address (rmi ad)
? S
v f v
value of Construction Qabor,
22 s1,;, 3 22Co'%�°
, profit)
17'Address City/State Zip
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Phone 0.') O
412c -GGGs
Applicant Name Address
4£eT'S�x 401 Jenw•ncr J'p•
City/State Zip
A.Cok. co. go5-2L
Phone
qjo-65s-o5aq
Contractor Address
�t F gear. tr. Six j t cag Mv JiN `N
city/state Zip
.C� 2s2L
Phone
&SB -0yo
Contractor City of FL Collins Sales Tax #
sales iax mxzbff is byaf cmn&z c Are you paying with your trust account?
- 4:�- 4526OU
P'Yes ❑ No
Is this a residential or commercial project? 19 Residential 0 Commercial
If residential, Is It 10 Single Family Detx:hed 0 Condo/townhome (single family attached) ❑ Duplex
0 Multifamily (apartment) ❑ Garage
If commercial, is It: ❑ Bank 0 Bar 0 Church 0 Hotel/Motel 17 Medial office ❑ Office 0 Retail
❑ Restaurant 0 Other (explain)
Is this building 50 years of age or more? ❑ Yes tjrNo If yes, you may mead to contact H/star/c Pn uPrvatlon
9 this Is for a demolition permit, what year was the building constructed?
D`prlor to 1975,. you wA/need an asbestos assessrn nt to subm/t wvd tills appl/cadW
Of
*If lawn sprinkier/bacidiow preventer, must Ust kensed plumber. If firshti C, must list licensed electrician.
Subconbucborm list Me wmµ3ny name or Oly ofR Cohn. llcease #
number MWW1cal Roofer r 23 3 / other
I hereby admowledge that I have read this application and state that the above information Is complete and oorrecL I agree to
campy with aft requtrements contained herein and sty ordinances and state laws regulating building construction. I know that a
permit is not vath! urriti It has been paid and lsa w&