HomeMy WebLinkAbout2913 Stockbury Dr - Applications/Reroof - 08/04/2014City of
Flirt 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. y`-
Application # NLW1Q1J(fl Date � if 1`I
For office use only
Sob Site Address (required)
Value of Construction (labor, materials, profit)
of 'Or.
8055 $8m.8%
Property Owner Name Address
City/State Zip
Phone
V-4, a 9.71D
a • 95 9
Applicant Name Address
City/State Zip
Phone
Contractor Address
City/State Zip
Phone
CAPITOL ROOFING INC. 6540 S, COLLEGE
FORT COLLINS 80526 970-223-560D
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report? ZHere
❑ Report
Sales tax number Is mvulred by all contractors.
Are you paying with your trust account? ❑ Yes
No
ph 0005 1 a C) c5
Is this a residential or commercial project? KResidential ❑ Commercial
If residential, is it: ❑ Single Family Detached ❑ Condo/townhome (single family attached) ❑ 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 ❑ No If yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
If pnor to 1975, you will need an asbestos assessment to submit with this application.
Description of work itMOVOL sb I'# �Ids r' W p G -___Aa& er%1t%e
�hsd- o Ltd'¢ Nw►e
*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 fit Collins license #
Electrician Plumber Mechanical Roofer1>4tGOther
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. CAPITOL ROOFING INC. Date
Print Name: Signature
Ir