HomeMy WebLinkAbout833 Napa Valley Dr - Applications/Reroof - 08/25/2014City of
Fort 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 (rot service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement K) Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater O Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer) lications will not be accepted
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Complete atlapplicable Information on .ie application. Incomplete app
Application it� lf./)!J� 4 E� G Date
For office use only'
Job Site Address (required)
Value of Construction
(labor, materials, profit)
$33 Not fc' vo-kkkLac F} oU.'VIC,
Co ga525
7-5,
2712-3
Property Owner Name Address
City/State
(:2).0 �5 C) FGS75
Zip
Phone
'773 -g(62- j
Applicant Name Address
City/State
Zip
Phone
Contractor Address
City/State
Zip
Phone
CAPITOL ROOFING INC. 6540 S. COLLEGE
FORT COLLINS 80526
970.223-5600
Contractor City of Ft. Collins Sales Tax n
Are you paying taxes here or by report?
KHere ❑ Report
CYNo
Sales tar number is required by allconrracrors.
Are you paying with your trust account?
❑ Yes
O06 J 124 (e
Is [his a residential or commercial project? OResidential ❑ Commercial
if residential, is it: 0(angle Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage j
if commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑Office ❑Retail
❑ Restaurant ❑ Other (explain)
Is this building SO years of age or more? ❑ Yes "o if yes, 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 will need an asbestos assessment to submit with this application.
of work
`11 lawn sprinkler/backflow prevente , must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or City of Fr Collins license
EIeRnUan
Plumber Mechanical --Rooter Other _..
I hereby acknowledge that I have read this application and state that the.above information is complete and Correa. L ayrcc w
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: Date
Print Name: CAPITOL ROOFING INC Signature
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