HomeMy WebLinkAbout1203 Rue Ct - Applications/Reroof - 09/17/2014Ave
���Cit���y}of �M Planning, Development & Transportation
281 N. F6111` Coil! fs Fort CoCnIs, CO 80524 O Box 580
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.
Application #
For office use only
Date �L'`L,�d t }
Job Site Address (required)
Value of construction (labor, materials, profit)
o/J GLn.
Property Owner Name Address
City/State Zip
Phone
1b lQn
114-.2Id_5
Apple nt Name Address
City/State Zip
Phone
Po Box 1326
Ft. Collins 80522
9705661884
Contractor Address
City/State Zip
Phone
Ticos Roofing Inc Po Box 1326
'Ft. Collins 80522
9705661884
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
I@ Here ❑ Report
Sales tax number is required by all contractors.
Are you paying with your trust account?
❑ Yes XNo
R-1686
Is this a residential or commercial project? IN Residential ❑ Commercial
If residential, is it: IN 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 prior to 1975, you will need an asbestos assessment to submit with this application.
of work Tear off to decking & replace w/ asphalt shingles provide re wired vents
*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 Ft Collins license #
Electrician Plumber Mechanical Roofer R-1686
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 Nam
Date 1-1-7-1q