HomeMy WebLinkAbout2242 Smallwood Dr - Applications/Reroof - 11/07/2014i(Sf-t
Cit Of Planning, Development & Transportation
FY 281 N. College Ave P.O. Box 580 113
ort Coins Fort Collins, CO80524
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 (pot 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 # SI <i 115(0� . Date `ll �I ow
For office use only
Job Site Address (required) Value of Construction (labor, aterials, profit)
2 S►vta(1�1.)co�l �1 r- Col��hS 8 3O-7 (-a 51
Property Owner Name Andress City/State Zip Phone
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Applicant Name Address City/State Zip Phone
Contractor Address City/State Zip Phone
CAPITOL ROOFING INC. 6540 S. COLLEGE FORT COLLINS 80526 970-223-5600 i
Contractor City of Ft. Collins Sales Tax p Are you paying taxes here or by report? �K Here ❑ Report
sales tax numterisreouiredbyall contractors . Are you paying with your trust account? ❑ Yes 5?Jo
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
It 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 d�,No if yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed? i
1f prior to 1975, you will need an asbestos assessment to submit with this application.
flescription of work T - �ktS�� r"n' ��iyo BPS 4r, � mace- n\, a-l� F
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`If lawn sprinkler/backnow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: tist the company name or City ofR Collins license a �ivl S Mr hie
i
Electrician Plumber Mechanical - Roofer Other I
I hereby acknowledge that I have read this application and state that the above information is complete and correct. I agree to
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comply with all requirements contained herein and city ordinances and state laws regulating building construction. I know that a i
permit is not valid until It has been paid and issued.
Applicant: ROOFING INC Date
Print Name: CAPITOL ROOSignature __ j