HomeMy WebLinkAbout801 E Drake Rd - Applications/Reroof - 03/10/2015 (2)From Affordable Roofing Inc 1.970.207.0289 Tue Mar 10 14:45:04 2015 MDT Page 7 of 20
Planning, Development & T ransportat?on
�F 281 N. College Ave P.O. Box 58C
�d�1t H Fort Collins, CO 8051=
pqPhone 970-416-2.7g0 Pax 224-b13=
OVER=TRM®%E-eNUR&Tnr=,R PERMIT'S ONLY
This application Is'to be used to apply for the following permits only (check all that apply), ❑ Air Conditioning
O Demolition (interior non-structural) ❑ Electrical Alteration (not service change) 01 Gas Lighter ❑ Gas Loa
0 Hestina Unit in Lawn Sprinkler O Mobile Nome replacement ❑ Roofing %1 Sewer Line ❑photo -voltaic
C+ Venbiaiicn R Water Heata- O Water Una ❑ Wood1^ellet Stove ',must be EPA certified, provide make, modal and
manufacturer).
Uornplete all applicable inPOrmatlon on the application- Incomplete applications will no-4 be accepted.
:`.ppliciors -_ 5 01$ b Dare
For office use only
lob Site Address (raquirad)
prOpery Oviner Warne
aiue of Construction (labor, materials, prori)
-115 (CIJLJ
ddress Citwstate Z11i3 phony
_V,a
:'ppiirt?C idflrne Address City/State -- Zip Phone ci-7
11 \-} l
Con�at ar _� Address �- "State Zio Dti-
- ,one
I
Contractor Cry of Ft. Collins Sales Tax .'-:'- i
s>r= -:�rsm. wrisrnuiredbyallcontactor. Are you paying with your trust account? )(Yes❑ No �
is his a residential or commercial projec?lteslden iai u Commet ai
-C�L-2rngie ramEry uecacnza u coneo(townhome (single family attached) El Duplex
0 MultiEmily (apartment) rJ Garage 1
1
IT commariai Is it: Cl Bank 0 Ear ❑ Church O tiatel/Motel R Medical oft -ice ❑ 0m1 ce ❑ Retail
I Restaurant Ct Caner (explain)
1 is this building 50 years of age or more? O Yes ❑ i\o dryam, you ma}rneEdto contactHisWCPf8seVaiio,•t
i'"Ns is for a demolition permit, whet year was the building constructed?
I: prior to 197,;, you W11 ilea, an asbestos aEgcc-ssment to submit snth fhls applicatrnn-I
Descripyan o; work
�tAl�.l�`E, l L'S�i11t1Q (� �QjC\C�K1 IC
- e Gr4'fYltl-' t)Yi
=-u lawn sprinider/bacialow pteventer, must list licensed plumber. IPflrA i mt a A/c, must list Ilcensid le m i an. ?
�_bcantracYors: list ire como3nyname arCi;yofFrCo//!ns/icenn .—
i e1r:G?ci.<n ?iumbcr t+1E[hanlcai 5
Other
ha:eay acknowledge that shave read this appliratinn and state that the above information is complete and cc, rect. I agree to
0milliy With a!i requirements comBined herein and city ordinances and state laws regulating building construction. T- know that e
Ptrrniit Is not: Valid until It has been paid and issued.
kuchlltan>r -r�� l
s tint t<iatne: i' nsy�� �. f signature `✓�t t D % f
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