HomeMy WebLinkAbout1030 Butte Pass Dr - Applications/Reroof - 09/15/2011SeP•15. 2011 6 : 0 1 P M Bob B e h r e n d s P,00fing
No•3856 P. 1
Plannlrg, Development & Tra,nsporiah.orn
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
OVER -THE COLITER PERMITS ONLY
This application is to be useA.to apply for the following permits only (check all that apply). ❑ Air Conditioning
❑ Demolition (interior.non-strugural) ❑ Electrical Alteration (not seriice change) ❑ Gas Lighter C3 Gas Log
❑ Heating Unit ❑ Lawn Sprmfder ❑ Mobile Home replacement X Roofing ❑ Sewer Line 0 Photo -voltaic
q Ventilation ❑ Water Heater 0 Water Line ❑ Wood/Pellet Stove (must be EPA certed, provide make, model and
if
manufacturer).
complete all applicabbblle�_information on the a�icatlon. Incomplete applications will not be accepted. .
App
lication.# ice! 0�7��% Date 5 �\
fOr'O�Ce case rmfy
Sob Site Address (required) Value of Construction.(labor, matarials, profit)
71
Property Owner Name Address ozj/state Zip Phone
�\-
Applicant Name Address Clty/state Zip Phone
U _
Contractor Lic Address City/State Zip Phone
Contractor City of Ft Coll! Tax Are you paying taxes here r by report? ikHere ❑ Report
s'alesraxnumc�ub ulredGvavcmaarars Are you paying with your trust. account. I 'Yes El No
Is this a residential ar comrrerdAproject? --I�KResidentlal ❑ Commercial
If residentiali is it=®3ing1efamlly Detached ❑'Condo/townhome (single family attached) O Duplex
O Mtil25'anffy (apartment) ❑ Garage
If commercial, is It ❑ Banh i798ar ❑ Church 0 Hotel/Motel ❑ Medical ofRce ❑ Office El Retail .
❑ Restaulmt ❑ Other (explain)
Is this building. bt3 years of agemr mare? t7 yes � o If*, you may need to canlwct Hesbr/c Preservation
If this Is for a demolition p er:a, what year was the building constructed?
If pffor to 1975, you will need wasbestos asses ment t submit w/th this applIcafion.
work
*If lawn sprinkler/back low pr2ve:fer, must fist licensed plumber. If first-time A/C, mist list licensed electrician.
Subcontractors: List bye M77p2Z3 name or Gty offs Coirrns.licensa
Elect) idan
luriter. hlachanical� Racfa Other
I hereby adcnoriledge that 1 have-z=_d t, is application and state that the above information is complete and CorreCt. t agree w
comply vAr.h all requirements=ontined herein and city crdiner!�_s and seta laws regulating buiiding ccnstvcbon. I 'Mew that a
permit is sat valid until it t,as3e--n paid and issued.
R
,Applicant \ �\ �`�CO 1w• \�'� -- r
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