HomeMy WebLinkAbout3608 Red Wolf Pl - Applications/Reroof - 10/01/2014Fort Collins
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fort Collins, 00 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 -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 # 0I qoq A) K Date 10/ 1 M
For ofte rm a*
lob Site Address (mgained)
Value of Construction (labor, materials, Profit)
36,09 Redi..io(F 'Pt
E 000
Property Owner Name Address
City/State Zip Phone
Carol Beo-n 3608 R&J,-jol'F PI
1-bC' has CD 865gt� q70-aA&,-5055
Applicant Name Address
City/State Zip Phone
Tono,*oo MMx 'ielJ ISO Rewncifon 5E Wollins eO 905a.5 303-7/0.0957
Contractor Address
Cdy/State Tip Phone
Cooper ecr64r tc-d6b/1 I9/a? Rcc+(mq%n
Sf- R-6of/ins Co 905a5 303-710 -Offf?
Contractor City of FL Collins Sales Tax #
Are you paying taxes here or by report? X Here ❑ Report
saastax mwmnert5mWredbya#wn&aaa s
Are you paying with your trust account?. ❑ Yes ANo
Is this a residential or commercial project? A Residential ❑ Commerdal
If residential, is it .Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
0 Multifamily (apartment) ❑ Garage
If commercial, is it ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
O Restaurant ❑ Other (explain)
Is this building 50 years of age or more? O Yes A No Ifyes, you may need to contact H& ork Preserrrabivn
If this is for a demollUon permit, what year was the building constructed?
Ifphor to 1975, you W11 need an asbestos assessrnent to su&& w/th this appticatlon.
Description of work
V,
SR 56Z 1 Sco(` y
*If lawn sprinkler/baddiow preventer, must list lid plumber. If first-time A/c, must list licensed electrician.
Subcontractors: /fit the company name or Cffy offtCo✓#ns fiaens e 0 Labor ;
Flecbtdan PkffnberMedmnh= Olr 1 Con S-E.. Other
I hereby acknowledge that I have read this application and state that the above information is complete and correct I agree to
oomply 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.
Print Applicant:
me: , onafr o I la) eI SIgnature
Date 101111