HomeMy WebLinkAbout1602 Fantail Ct - Applications/Reroof - 10/28/2011Oct 28 11 12:56p AFFORDABLE RFG /FCR 970207289 p.1
City of
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fort corms, CD 80524
Phone 97G 416-2740 Fax 224-6134
OSIER -THE -COUNTER PERMITS ONLY
This application Is to be used to apply for the following permits only (check all that apply). ❑ Air Conditioning
P Demolition (irderior non-structural) ❑ Electrical Alteration (not service change) a Gas Lighter ❑ Gas Log
p Heating Unit D Lawn Sprinkler ❑ Mobile Home replacement 17 Roofing ❑ Sewer Line ❑ Photo -voltaic
l7 Ventilation 17 Water Heater ❑ Water Line ❑ WoodlPellet Stove (must be EPA certified, provide make, model and
:manufacturer).
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application
# Date
Job Site Address (lequued)
Value of Consbruction (tabor, mat�erats, Profit)
u�
I On o
:Property Owner Name
Address
City/Statle Zip
Phone
In
Applicant Name
Address.
City/State Zip
Phone
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,Contra or
Address
city/Statezip
Phone
,contractor City of Ft Collins Sal T
#
Are you ing taxes here or by report. Here ❑ Report
Are you paying with your trust account- ❑No
, sra,r»rmb�an rr�bya�rarrbaems
;is this a residential or commercial project? —OResiderttial ❑ Commercial
'.If residential, is it: Al Single Fanny Detached ❑ Condoltownhome (single family attached) 0 Duplex
17 Multifamily (apartment) ❑ Garage
if commerdal, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑Meth®i office ❑ Office, ❑Retail
Q Restaurant ❑ other(expiatn
Is this building 50 years of age or more? ❑ Yes o !f yes, you may new to contactHrsraric Pnnrdtron
If this is for a demolition permit, what year was the building cons ructed?
i:Ifprlor to IS4 you wi# need an asbestos assessment to submit rvl8ri rfiis apPGcabon
of work
*If lawn sprinkler/barldlow prevent2r, must list licensed plumber. Ir first-time A/C, must list licensed electrician.
Subcontractors List die camPanyname or dTy of Ft Colrrns license 'f
EkCGldan --
Plumber Medraniol RooferL Other
T hereby admowledge that I have read this application and slate that the above infnnnation Is complete and correct I agree to
comply with all requirements contained herein and city ordinances and state laws regulating building eonstrtrction• I know that a
permit is not valid until it has been paid and issued. ( f
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Applicant' J��' 1 Ii 1
Dace
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