HomeMy WebLinkAbout707 Butte Pass Dr - Applications/Reroof - 09/22/2014[' �' * -qn�
City of
/ 11 �_t�0l Collins
Manning, 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 se change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement af 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 # [� Gl1 �D O Date "( Y
For offte use only
Job Site Ad 4 ),
Value of Construction n-bor,
44
Property 0 Nam / A
Address
City/state Zip Phone
�VM� 1.1J1
�
31 - �5
Applicant Name
Address
City/State Zip Phone
3, a
030
a
Contractor
Address 1
city/state Zip Phone
S
Contractor City of Ft Collins tales Tax
#
Are you paying taxes here or by report? ®'Here ❑ Report
saksraxmnnle� rapulredbya/iconba�rs
_50� 5�d-
Are you paying with your Dust account? ❑Yes ®'No
Is this a residential or cepr merciai project? C9"Residential ❑ Commercial
If residential, is it: n 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 ❑ OUher (explain
Is this building 50 years of age or more? O Yes No If yes, yrw may neietfto contact YMdric nws wUon
If this is for a demolition permit, what year was the building constructed?
Ifpnbr to 1975, you W11 need an asbestos motto submit wfth tftaWkebba
Description of work
*If lawn sprtnlder/baddiow preventer, must Ust licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List LhecnrnpanynameoratyoffrCollinsLtense#
Bectrtdan Plumbs Methankal Roofer _R-.ell5I Other
I hereby admowtedge 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 dty ordinances and state laws regulatirng building construction. I Imow that a
permit is not valid until It has beers paid and Issued.
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