HomeMy WebLinkAbout2803 Stonehaven Dr - Applications/Reroof - 09/22/2014-:t� 16n3
City 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 Uiot 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 # :�5(L-tD sLeT Date 01I Plla0l
For office use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
9,803
Property Owner Name Address
City/State Zip
Phone
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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 # Are you paying taxes here or by report?
24 Here ❑ Report
Yes A�No
Saiestax numterisrecuiredbyall contractors. Are you paying with your trust account?
❑
60OSl�.Cjtn
Is this a residential or commercial project? Cktesidentiai ❑ Commercial
If residential, is it: IZSingle 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 50 years of age or more? ❑ Yes O-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 app/ication.
of work
`If lawn sprinkler/backnow
ay.
V n
r, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or City of Ft Collins license #-},1V15 M c
Electrician
Plumber Mechanical 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: Date
Print Name: CAPITOL ROOFING INC Signature
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