HomeMy WebLinkAbout507 Spinnaker Ln - Applications/Reroof - 11/10/2014I S31
Fort Collins
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 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 # Date
For ofte use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
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Property Owner Name
Address
City/State Zip Phone
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Applicant Name
Address
City/State Zip Phone
Contractor
Address
City/State Zip Phone
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Con ractor City of Ft. tins Sales Tax #
Are you paying taxes here or by report? ALHere ❑ Report
Sales tax number Isiequnedbyall contractors.
Are you paying with your trust account? ❑ Yes fZNo
Is this a residential or commercial project? 12(Residential ❑ Commercial
If residential, is it: Mingle Family Detached ❑ Condo/townhome (single family attached)
If commercial, is it:
❑ Multifamily (apartment) ❑ Garage
❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes !$No If yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
If prior to 1975, you will need an asbestos assessment to submit with this application.
❑ Duplex
xl of work
- 19-
❑ Medical office ❑ Office ❑ Retail
*If lawn sprinkler/backflow prWenter, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or City of Ft Collins license # �I(
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Electrician Plumber Mechanical Roofe Other
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 r ulating building construction. I know that a
permit is not valid until it has been paid and issued.
Applicant: j . rz - /
Print Name: �l"l�1 I`�'� �' SignatureDate