HomeMy WebLinkAbout2808 Sitting Bull Way - Applications/Reroof - 08/04/2014City of
Fort 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). ❑ Air Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ® Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable Information on the application. Incomplete applications will not be accepted. `
Application # 31LMD 13
For office use only
Date g% Lk �L{
Job Site Address (required)
Value of Construction (labor, materials, profit)
Co
Property Owner Name
Address
City/State Zip
Phone
W
a
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Applicant Name
Address
ity/State Zip
Phone
Contractor
Address
City/State Zip
Phone
CAPITOL ROOFING INC. 6540 S. COLLEGE
FORT COLLINS 80526
970-223-5600
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
Z Here ❑ Report
sales tax number is reouired by all contractors.
Are you paying with your trust account?
❑ Yes 7 No
000'IT 1610 fo
Is this a residential or commercial project? B Residential ❑ Commercial
If residential, is it: ❑ Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Chu ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes RI No If yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
If prior to 1975, you will need an asbestos assessment to submit with this application.
Description of work (fin.- 1b 2p{21h c P Cor)� tSL ETA F -Tirnbecl(�c� - 4.lec�tY�er
ux,pL se, N um bZ- oy 5�V c i es 7 1
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or City of Ft Collins license A -A1 v\ S M < aanT2
Electrician Plumber 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 and state I ulating building construction. I know that a
permit is not valid until it has been paid and issued.
Applicant:
Print Name: CAPITOL ROOFING INC. Signature Date
IMS
41