HomeMy WebLinkAbout519 Spinnaker Ln - Applications/Reroof - 10/23/2014Oct 22 14 07:12p
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City of
port o�L wRns
IW -CO - Z 0 (o Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970-116-2740 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 inforimation on the application. Incomplete applications will not be accepted.
application # B l q J'09 S9 Date 3'3 • Q
For ofte use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
51 i IJ Q
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Property Owner Name
i
Address
,/\ Gty/State � . L U . ZIP IE5D, Z s Phone
Applicant Name
Address
City/State iHV1-?— bA$ WIC�) Phone --308—
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Contractor
Address
City/State Zip Phone
Y
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report? ❑ Here ❑ Report
Sales 4wnumber 6regWredbya#conacbm
Are you paying with your trust account?\f3,Yes ❑No
Is this a residential cc ercial project? esidential ❑ Commercial
If residential, is It: Single Family Detached ❑ Cando/townhome (single family attached) ❑ Duplex
ultifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar i7 Church 0 Hotel/Motel ❑ Medical office ❑ Office ❑ Retarl
❑ Restaurant 0 Other (explain
Is this building 50 years of age or more? ❑ Yes Ifyes, you may need to contact HistorfcPfus&wbbon
If this is for a demolition permit, what year was th b llding constructed?
Ifpfior to 1975, you will need an asbestos assessment to subm/t with this application.
Description of work I Pir.� . r.EF- CA Q F-r-r E 4 uE�--p i A-ej= f . •• � , , n C` a-2&-Ti
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
subcontractors: Ust the company frame or City of Ft Collins license #
Electrician Phimber Mechanical Roofer 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 regulating building construction. I know that a
permit Is not valid until it has been paid and issued.
Appicant: t Print Name-
t.
Date (U. Z 3. 1 Li
LC-7 i