HomeMy WebLinkAbout4538 Seaway Cir - Applications/Reroof - 07/15/201411/01/2013 13:22 9705872178 MASTER ROOFING CO PAGE 01/01
/ laning, Development & Transportation
�10" Uv P281 N. College Ave P.O. Box 580
city. O'F Fort Collins, Co 80524
ort Collins Phone 970-416-2740 Fax 224-6134
OVER. -THE -COUNTER PERMITS ONLY
This applia don is to be used r O Gas Log
to apply for the following permits only (cheek all that apply). O Air Conditioning
p Demolition (interior non-structural) O Electrical Alteration (not service change)
❑ Gas Ughte
Photo-voltaic
p Heating I, ❑ earaeLiiHp ement Cl Roofing
model and
❑ Ventilation O Water Heater Sprinkler
Linewoo�elist Stove (must be PA certified, prodemake
manufactur,10. Ilete applications will not be accepted.
Complete s III applicable Information on the application. noomP
Application #_._. Date
For oboe use aftly
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7ob�Si�e l Value of CAnstruConstruction(labor, materials, profit)
A dtIrjs (requW)
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,+vne
Property 0r Name
Address City/�
Zip
Phone
Applicant f tam f
Address /State
n._ ,
w s, w I.6 .� : ^ j _ _ ) �.
Zip
n;4
Phone
'PAO.—S t-A
Contractor ti Address . ' Gty/state Zip Phone
Contractol City of Ft. Collins4les Tax # Are you paying taxes here or by report? O Here eport
-Blew rnunaer&requhedbya#conbwaws Are you paying with your trust account? O Yes 1 ❑ No
Is this a re sklenttal or mmercial project? kesidentlal O C6mmerdal
If resident al, is R.
Single Family Detach ❑ Condo/townhome (single family attached) O Duplex
O Multifamily (apartment) ❑ Garage
If eommer.ial, is It: O Bank O Bar O Church 13 Hotel/Motel O Medical office ❑ Office ❑ Retail
O Restaurant O Other (explain)
Is this bull f ing 50 years of Moor more? ❑ Yes O No !f yesy you may need to contact Hlsmrk PlrServatron
If this is fc r a demolition permit, what year was the building constructed?
Af prior io 1975, you wt// need an asbestos awes ment to subm/t wffh tiffs appACatlon.
Descriptl )n of work
*If lawn sit ikler/baddlow prevent+er, must list licensed plumber. If firs"me A/C, must list licensed electrician.
r'
Subcontr rdtorm t kt the company name or Oty of R Lb!/Ins lionise #
dedridan_ _ Plumber. Mechanical Roofer.. Other
I hereby a iowwledge that I have read this application and stabs that the above Information Is Complete and correct. I agree to
comply wif h all requirements contained herein and city ordinances and state laws regulating building construction. I know that a
permit is rx* valid until it has been paid end Issued.
Applicant: _
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