HomeMy WebLinkAbout1514 Coral Sea Ct - Applications/Reroof - 11/01/2011Nov 01 11 11:36a AFFORDABLE RFG /FCR
970207289
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pity of
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Planning, Development a Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970-416-2740 Faoc 22+6134
OVER-THE-COUNTER PERMITS ONLY
This application is to be used to apply for the following permits only (check a8 that apply)_ ❑ Air Conditioning
0 Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
O Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
.� Venhflation ❑ Water Heater ❑ Water Line ❑ WoodlPellet Stove (must be EPA certified, provide make, model and
manufacturer).
:Complete all applicable information on the application. Incomplete applications will not be accepted.
4pplit�tion #
ForoA9ce use only
Date I i ' r ;
i3ob Site Address (igcured>
Value of Construction (labor, materials, profit)
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OroperLy6wrier Name
Address
City/State Zip Phone
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'Applicarit NNaame
Address
city/state Zip Phone
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'Contrz&w
Address
City/State Zip Phone
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`:.Contractor City of Ft Collins Sal Tjk
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Are you Ing taxes here or by report_ Here O Report
salertw„umber&rpya adfyaffamoacbm
Are you paying with your bust acrnurrt es ❑ No
Is this a residential or commercial pnhject? Residential ❑ Commercial
LIf residential, is it: ` Q Single Family Detached ❑ Condo/townhome (single family attached) ❑Duplex
❑ Multifamily (apartment) O Garage
If commercial, is it ❑ Bank ❑ ear ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ other (explain
As this building 5o years of age or more? M Yes o If yel, ycuMay needlo ConmctKstvrfCPresert fOn
jf this is for a demolition permit, what year was the building constructed?
.Ifprlor to 1975, you will need an asbe5b75 assessnWtm submit aridi this appllmtron.
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Desoription of yvork `
2U—u O I.
*If lawn sprinlder/bactiiow preventer, must list licensed plumber. If first time A/C, must list licensed electrician.
s5ubmntractors: List Me company name or6LyofaCoffins ffmnse#
Electidan . plumber Mechanical Roofer Other
I hereby admowledge that I have read this application and state that the above information is oomplete and correct I agree to
comply with all requhemerrts contained hereinand city ordinances anal state laws regulating building construction. I know that a
permit is not valid until it has been paid and issued. 1
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Applicant: ,� nature\ %1 V C V Y Date i
Print Name, X'1� i �i i �':lirl,l ;MJ f � —
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