HomeMy WebLinkAbout5006 Redbud Ct - Applications/Reroof - 08/05/2014This application is to be used to apply for the following permits only (check all that apply). G Air Conditioning
❑ Demolition (interior nen-structural) 0 Electrical Alteration (not service change) 0 Gas Lighter ❑ Comas Log
❑ Heating unit ❑ Lawn Sprinkler ❑ Mobile Home replacement Roofing ❑Sewer Line Q Photo-voltele
0 %ntilatlon 0 iNater Heater ❑ Water Line ❑ woodlPeiiet Stovo (must be EPA ciiMed, provide make, model and
manufacturer).
Cornolsteall applicable Information on the application. Incomplete applicatlone,vAll not be accepted.
Application # Date �� . O .'Ld�•
rurofmce ass only
Job Site Address (Wvfred)
Value of Construction (labor, materials, prd*
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CA- tk 2 8U0."0
Property Owner Name
Address City/State Ztp Phone
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Applicant Name
Address City/state j ZIP Phone q W -
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2:vic. oZirl W- -rriib tzd� Ca $oS S aa'7-o6oa
Contradgr
Address ty/state Zip Phone
Contractor City of Ft. Collins Sales Tax ii Are you paying taxes here or by report eitlere ❑ Report
5'elW raxnrsnbwArreauftgd by59C'bRC&M Are you paying with your trust account? es IM NO
Is this a residential or commerdal project? I ResIdentlal 17 Commercial
If residential, Is it: 0 Singie Family Det w-hed Q Condoltownhome (single family attached) ❑ Duplex,
0 Multifamily (apartment) ❑ Garage
if commercial, is it: EJ Bank 0 Bar ❑ Church 0 HotellMobel ❑ Medical office 0 4ftice 13 Retail
13 Restaurant ❑ Other (explain)
Is this building So years of age or more? ❑ Yes ONO 1Pyd Yap mayrread to corrtartHlslwicPrlserwifOn
If this is for a demolition permit, what year was d4butiding r7ons nilikad?. ,
IPperior to i9;5,7 Yew Y01 need an a--*e9 ar a5S8ZTnent W submit xdeb MISApwAeatlon.
Des rip -on of work —
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*If lawn sprtnider/bacldlow preventuer, must list licensed plumber. If first-time A/C, must Ust licensed electrician_
Subcontractors'. Ustd'recarrryenYnawarOb'dfaLW 75'k&7W'A
l3ectrdsn_._ plumber Mecnani�L Roarer iz_ V-T Other.
I hereby acknowledge that I have read this application and state that the above inrormation is complete and correct I agree to
comply with an requirements contained herein and city ordinances and state laws regulating building construction. I know that a
permit Is notvaild until it has been paid and issued. '
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PrpirpiititVama �BKtatYtaQ S SignatuCe