Loading...
HomeMy WebLinkAbout3906 Moss Creek Dr - Applications/Reroof - 08/25/201408/27/2014 04:28 3032844067 RED DIAMOND ROOFING PAGE 08/09 Planning, Development & Transportation aty of 281 N. College Ave P.O. Box 580 F&t ColtlnS 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) M Gas Lighter ❑ Gas Log © Heating Unit ❑ Lawn Sprinkler 0 Mobile Home replacement Roofing ❑ Sewer Line ❑ Photo -voltaic ❑ Ventilation ❑ Water Heater d Water Line CI Wood/Pellet Stove (must be CPA certified, provide make, model and manufacturer). Complete all applicable information on the application. Incomplete applications will not be accepted. Application # 13D H 0--7 ®-7 —7 pate Cnr nJlne< Jje nniv Job Site Address (required) `fir-' Value of COnstruCtiott (labor, materials, profit) 1, 8J0 '3 9 o (0 , Property Owner Name Address C al -I; City/State Zip Phone UtL1 cM�14-0 Applicant Name Address Gty/State Zip Phone Contractor Address City/State Zip Phone R�cl Dia gal -j()C0 6 �nq o2Z.l I-'et3 � � Contractor City of Ft. Collins SaleYTaU Are yo aying taxes here or by report?4 Here 0 Report 17 Yes No sales iaxad b0 Larequ1redbyal1 tnntractnrs Are you paying with your trust account? Is this a residential or commercial project? "K Residential O Commercial If residential, is it: XSingle family Detached ❑ Condo/townhome (single family attached) ❑ Duplex 11 Multifamily (apartment) ❑ Garage If commercial, Is It: ❑ Bank ❑ Bar 0 Church 0 Hotel/Motel 13 Medial office ❑ Office ❑ Retail ❑ Restaurant 0 Other (eXpla n) Is this building 5o years of age or more? 13 Yes No !f yes, you may need to contact Mstorlc preservat/on 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 *If lawn sprinkler/backnow preventer, must list licensed plumber. if first-time A/C, must list ilcensW electrician. Subcontractors: ,Ust the company name or City of R' 0111ns llCUM # 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 laws regulating building construction. I know that a permit Is not valid until it has been paid and issued. Applicant: Print Name: D Dvt Signature0- ((-- Date 5