HomeMy WebLinkAbout321 Albion Way - Applications/Reroof - 09/08/2014Sep 081410:47a Severe Weather Roofing
970-223-3383 p.3
City of Planning, Development & Transportation gle
281 N. College Ave P.O. Box 580 /t:7-01
FOr `} Cotti nS Fort Collins, CO 80524
`..- Phone 970A16-2740 Fax 224-61M
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-vormic
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Woad/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 # B 1!1679 Date 9/8/2014
For office use onfy
Sob Site Address (required)
Value of Construction (labor, materials, profit)
321 Albion Way
2200.00
Property Owner Name
Address
City/State Zip
Phone
Darlene Blenkers
321 Albion Way
Fort Collins CO 80526,
Applicant Name
Address
CiWState Zip
Phone
John Anderson
PO Box 2207
Fort Collins CO 80522
970-223-2455
Contractor
Address
City/State Zip
Phone
Severe Weather Roofing
PO Box 2207
Fort Collins CO 80522
970-223-2455
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
Here ❑ Report
Sales fax number is mquimd by all contractors
Are you paying with your trust account?
❑ Yes ❑ No
50255
Is this a residential or co mercial project? V Residential ❑ 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 mare? ❑ Yes ❑ No If yes, you mayneed to contactHrstoricPreservatfon
If this is for a demolition permit, what year was the building constructed?
Ifpnor to 1975, you will need an asbestos assessment to submit w/b5 this application.
Description of workRernoyn 951 amphniltsquares . decking and renhanin with P9 Rsoltalt
*If lawn sprinkter/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or G1y of Ft Collins lkense #
Electrician Plumber Mechanical Roofer
A7M
I hereby acknowledge that I have read this application and slate 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.
t Name:
rrt: Print
Print Name _John Anderson signature T f ( Gate _9108/2014