HomeMy WebLinkAbout3736 Stratford Ct - Applications/Reroof - 10/16/2014Planning, Development &Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
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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 -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 # F>1 L' (00 '( � Date I� 1 a 1 I`-t
For office use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
3736 64-r'c4- rd C-6,
1e oo
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Property Owner Name
Address City/State
Zip
Phone
bkleoyiee tYe,.Yes
3736 3frc, { rcf jC6 Co
.905,zs
qTo-Y�(3-�93
Applicant Name
Address City/State
Zip
Phone
JDn4i%.� j-(wkfr el�
(812 Pee("'7 forl f-� F�, a'/"Zy /-0
9,952u
3o3_y/o-o�59
Contractor
Address City/State
Zip
Phone
C'oo er
1S12 Pefcinyl, , St FEC-t11J lO
90se-S
��3-9to-o�sq
Contractor City of Ft. Collins Sales Tax #
Sales tax number is required by all contractors. Are you paying with your trust account? ❑
Yes XNo
Is this a residential or commercial project? ,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 more? ❑ Yes KNo if yes, you may need to contact Historic Preservation
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 application.
Description of work /Resi deszl-rc�( Re -roof 01«k'rrt
�sl0hcz f 5hrn�leS 3'{ S� Z S¢ons/
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/c, must list licensed electrician.
Subcontractors: List the company name or City of Ft Collins license # Z ter-
,
Electrician Plumber Mechanical Roofer C on S'hrLtcfl6aer
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:
Print Name: ° K v e (� Signature Date