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HomeMy WebLinkAbout513 Towhee St - Applications/Reroof - 03/17/201503-17-'15 13:00 FROM -Premier Roofing 9704848308 T-291 P0002/0002 F-581 City of N. Planning, va Avep ant & Transportation BOX 580 . 6rt Collins Fort Collins, CO 60524 �..- Phone 970-416-274D Fax 224.6134 OVEWTH&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) la Gas Lighter ❑ Gas Log ❑ Heating Unit 0 Lawn Sprinkler 13 Mobile Home replacement 17 Roofing 11 Sewer Line ❑ Photo -voltaic ❑ Ventilation 0 Water Heater 0 Water Line 17 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 # rrrolnte use only Job Site Address (mqu/red) 51 �•TOv, V)e-C Property Owner Name Address Name I Address 3r Address Contractor City of Ft. 001145 Sales Tax # SalesW numbed? requiffld bya/lcanbaciois, Date Value of Constmedon (labor, materials, profit) = City/state Zip Phone City/state zip. Phone City/state Zip Phone Areffyou paying taxes here or by repotV orgere 13 Report Are you paying with your trust account? a Yes 13 No is this a residential or eom clal prgjeet? [joiQldential O Commercial If residential, is it: Dingle Family Detached 0 Condo/townhome (single family attached) 13 Duplex 0 Multifamily (apartment) Cl Garage If commercial, is it: L] Bank 0 liar ❑ Church E3 Hotel/Motel ❑ Medical office ❑ Office ❑ Retail Cl Restaurant E3 other (explain) Is this building 50 years of age or more? ❑ Yes >fy youmayneedMcnntactN�sEarlcPrroatlon If this is for a demolition permit, what year was the building constructed? &.0or to 1975, yna wIllneedan asb&ft assessment to subm/t with t Is 4p011c0ft *If lawn sprinkler/b Wow preventer, must list licensed plumber, If first-time A/C, must list 11cemed electriclan. Subcontractors: u0ffiaCompanyHOW orCRY ofRal//ns11&wsei` E e'cbiclan Piumber� Mechanloat Roofer. Other I hereby acknowledge that I have read this application and state that the above information Isminplete and correct I agree to comply with all requirements contained herein and city ordinances and state laws regulating building construction. I know that a penult is not valid until It has been paid and issued. applicant; L i tlAte- 03 ^ �� Print Name., irl Blgnature D(25�'