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HomeMy WebLinkAbout3760 Carrington Cir - Applications/Reroof - 08/11/2014Aug 11 1412:46p p.31 city of Fit Collins Planning, Development & Transportation 281 N. College Ave P.O. Box 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). O Air Conditioning ❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log ❑ Heating Unit ❑ Lawn Sprinkler O Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo-vottaic 17 Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and manufacturer). Complete all-appitcableinfonna fon_on the application. Applicatio�t ��u F") A-)7�# G1"1�--iu� b') for off use only .... Incomplete applications will not be accepted. Date i� - /% -1y .lob Site Address (re9uked) Value of Construction (labor, materials, profit) C? uD Property Owner Name Address City/state Zip Phone Applicant Name Address City/State Zip Phone C -' r-t 'eLZ e Q C - tL _ t � ' Contractor Address City/State Zip Phone Contractor City of Ft Collins Sales Tax # Are you paying taxes here or by report? ❑ Here ❑ Report sak 1axmrmber&raw#edbya1/cnndactom Are you paying with your tent account?' ees ❑ No e - Z C C-0. Is this a residential or coMmerdal project? tXtesidential ❑ Commercial If residental, is it ; (bugle Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex 'E Multifamily (apartment) ❑ Garage If commercial, is It: ❑ Bank 17 Bar ❑ Church ❑ Hotel/Motel © Medical office ❑ Office ❑ Retail ❑ Restaurant ❑ Other (explEudlyillng Is this building 50 years of age or more? ❑ Yes lfyes, you may need to contact HLciorit Pr�rvabon If this is for a demolition permit, what year was constructed? Ifprlorto 1975, you will need an ag)%Wsassessrnentto mbmt wrtfi this app%orlon. Description of = z J *If lawn spri Ibacdiow preventer; m list licensed plumber. If first-time AIC, must list licensed electrician. Subcontractors: List dre company name or Gty of folUns license # 9erbidan Piurriber Mechanical Roofer 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 a state laws regulating building omsbvction. I know that a permit is not valid until it has been paid and Issued. Applicant: Print NamA, Signature. Ct7G — 377 Le 2Cr +A- _J CC1 c6c)W-