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HomeMy WebLinkAbout5136 Sawgrass Ct - Applications/Reroof - 10/09/2014Oct 08 14 08:50p I LI - Cv- le?) p.2 City of /Coltins 1 � 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 (not service change) ❑ Gas Lighter ❑ Gas Log ❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo-valtaic ❑ 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 #_ a � Date !O - IR 1 Li For ofte use only Job Site Address (requlred) Value of Construction (labor, materials, profit) I &SRI0C-D(LrtS GT a'IO Property Owner Name Address City/State 'r.F .(a. Zip SJSz� Phone q 70 Applicant Name Address (C-7Q0J[ IL;,City/State i i iZ Ht3�H Zip 5e10 ��haS Deal, `<'`��ik. Phone P,(,CUI��zi cu�- Contractor Address &-)Q) ALr,4l�Gte/State �L iZ AiSt•,t t ZiP r-t)-vs- L Phone 1C-L' OpkL ;T-r�C-iZ;�S e. Cu. SSL'Ivy Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? ❑ Here ❑ Report sar�starnumaerlsreg,lredayancnneacros. Are you paying with your trust account? TYes ❑ No Is this a residential or co mercial project? WResidential ❑ Commercial If residential, is it: iXSingle Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex ❑ Multifamily (apartment) ❑ Garage If commercial, is it ❑ Bank 17 Bar ❑ Church ❑ Hotel/Mom ❑ Medical office ❑Office ❑ Retail ❑ Restaurant ❑ Other (explain Is this building 50 years of age or more? ❑ Yes (explain Ifyes, you may need to contact Hstoric PreservatYon If this is for a demolition permit, what year was the building constructed? Ifprior to 1975, you will need an asbestos assessment to submit with this apollcation. Description of world r?�(6 60 CLZA :ik) -i-iy deck' i p inr U ),3L t n� C 3�_rarr 9t_ *If lawn sprinkler/baddiow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician. Subcontractors: Ust the company name of G4' of Ft Collins Ilrense # Elechidan 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 ^'j/ /Ell Print Name. eX 1 I pit e/ Signatu rate a{©• `f -/ 216