HomeMy WebLinkAbout900 Driftwood Dr - Applications/Reroof - 08/08/2014Planning, Development &Transportation
City of I 281 N. College Ave P.O. Box 580
Fort Collins Fort Collins, CO 80524
`- Phone 970-416-2740 rax 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 ElMobile Home replacement ❑ Roofing ❑ SeweriLine ❑ 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 # o5i UUW03
For office use only
Date 943 — N
Job Site Address (required
aj�')
Value of Construction (labor, materials, profit)
Property Owner Name
Address
City/State Zip
Phone
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Applicant Name
Address
City/State Zip
Phone
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)70-61049
Contractor
Address
City/State Zip
Phone
Contractor City of Ft. Colli s Saes Tax
Salestaxnu Zre lsl required by all contractors. T �V %7 Are you paying with your trust account?
�1Ge5 ❑ No
Is this a residential or commercial project? 4 Residential ❑ Commercial
If residential, is it: J?�single Family Detached ❑ Condo/townhome (single family attached) 0 Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, Is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ other (explain)
Is this building 50 years of age or more? ❑ Yes fXNo If yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed? �f
If prior to 1975, you will need an asbestos assessment to submit with this application. , J
Description of work
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list
Subcontractors: List the company name or City of Ft Collins license #
Electrician Plumber.
Mechanical Roofer
Other
R
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 laws regulating building construction. I know that a
permit is not valid until it has been paid and issued.
Applicant:
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