HomeMy WebLinkAbout7245 Fort Morgan Dr - Applications/Reroof - 07/22/2011Planning, Development & Transportation
City. Of 281 N. College Ave P.O. Box 580
Collins Fort Collins, CO 80524
"t
e..hPhone 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). Q Air Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter O Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line Cl 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 # 0 Date
For offce use only
Job Site Address (required)
Value of Constructlon (labor, materials, profit
b -1 S rk thqui
It. 51 +- Co I' PIS CD 000
5
Property Owner Name Address Li
City/State Zip
Phone Ca
n v�tlim 023 Q. rL 0
2tx
W SDI
Applicant Name Address
City/State Tip
Phone
f
ContracWr Address
City/State Zip
Phone
Contractor City of R. Collins Sales Tax #
Are you paying taxes here or by report?
Here ❑ R ort
sales tax number is required byall mnUadors
Are you paying with your trust account?
El Yes � 0
Is this a residential or commercial project? L�KResidential ❑ Commercial
If residential, Is it: PrSingle Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: C3 Bank ❑ Bar ❑ Church l7 Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? 0 Yes C3-a(o if yips, 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 wl/l need an asbestos assessment to submit wlth this application.
Description of work
S
*If lawn sprinkler/baddlow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors- List the company name or Gty of Ft Col/!ns license 0
SedHdan Plumber Mechanical Roofer
Other
I hereby acknowledge that I have read this application and state that the above informat on 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:"Z I I
Print Name: Slgnatur� Date