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HomeMy WebLinkAbout719 Butte Pass Dr - Applications/Reroof - 09/05/201409/04/2014 22:48 3032844067 RED DIAMOND ROOFING PAGE 02/04 F8i'ryttoitIns planning, Development 8t 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 (not se�rvfie change) 0Gas Lighter ❑ Gas Log * Heating Unit 13 Lawn Sprinkler C1 Mobile Home replacement LWRooflng ❑ Sewer Line Gi Photo -voltaic ❑ Ventilation Cl 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 # S 0�-• bate o ttt4 ror office use on/y Job Site Address (required) Value of C/oonstruction (labor, materials, profit) I. igoo Property Owner Name Address Clty/Stake ZIP Phone C o 1 i r,. c.o 8D6 2 f� Ito - �.-�7 Applicant Name Address City/State ZIP Phone S.. Contractor Address City/state zip Phone Reck Ltd p -loco 3Y7adt 1:n /2iU� Q% 6gPi--b?-9 Contractor City of R. Collins Sal&rau Are yo aying taxes here or by naport?)A Here ❑ Report © Yes No .salcs� nvm4w� &mw edbya#co fmcmms Are you paying with your trust account? Is this a residential or cormmerdal project? ®'Residential ❑ Commercial If residential, Is it: ®'Single Family Detached [3 Condo/townhome (single family attached) 13 Duplex E3 Multifamlly (apartment) 13 Garage If commercial, is it: ❑ Bank CI bar O Church E3 Hotel/Motel ❑ Medical office la Office ❑ Retail © Restaurant ❑ Other (explai Is this building 50 years of age or more? o Yes o If yw,,you may need to cWteed HMO& Pmservalion If this is for a demolition permit, what year was the building constructed? _ ffpdor to J975, you w/Il need an asbestos assessment to submit alth 8iirs application. Desaipdon of work *If lawn sprinkler/bad0ow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician. Subcontractors., List the company name or cry of Ft Collins Ames pedddan I Plumber. MechW=1 _ ___ 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: O W% re T Print Name: I 514aature Dabs