HomeMy WebLinkAbout736 Larkbunting Dr - Applications/Reroof - 03/24/2015From Affordable Roofing Inc 1.970.207.0289 Mon Mar 23 09:26:20 2015 MDT Page 2 of 2
'Oty o f Planning, Deveiopment & T ransoar:atio.
281 N. College rive P,O. Sox 58c.
Fort Colhns, Fort Collins, CO 80324
phone 970-416-2740 Fax 224-613
U i Rmxi�35E-"uOO II! B ER IERMI��
This application is to be used to apply for the following permits only !Check all that apply), ❑ air Condiiionino
=7 Demolition (interior non-siruciural) ❑ Electrical Alteration (not service change) 0 Gas Lighter Cl Gas Lon -
`-1 HaaiinO Unit ❑ Lawn Sprinkler ❑ Mobile 4ome replacemani Q Roofing Q Sewer Line Q Photo -voltaic
Q Van6la;ion 1 LVatar Heater ❑ %dater Lins ❑ Wood!Peile.. SiQVE (must be EPA certirled. orovids make, z. ;
manufacturer?. : od_r an,.
Cornple a all a130cable inlOrmation o the apFlication. Incomplete applications will not be accepted.
catC-
or niirce use only
eb Site Address (required)
Dc
T uaiue of Construction. (labor, materials, pro -,It)
4
�r
U'Yvner Na'ne address
i
-�
—"----
City/State T t=
e
anon..
i.�. ,r
�.... ,.
ppltc3gt Ntime
I r; n Address
a.� ,
r�iylSwtz �i,
PhonE- o��—
l-7
Contractor _
7(1 .2 G
..� Address
.�iy-`"State Zip
p----��-_.�
hone
`• Contractor My of Ft. Collins Sales Tax =
—
=-:='s rmrnuerrsrcwtenrpy 2U[nntrz'-Orr
Are you paying with your ;rust account? Yes
L No
•"'_ _ :=swoerma! or commercial project? I3 Rasioential Q Commercial
"r`rzridffr"uaf, <s Ii Q Stngle Family Detached ❑ Cc
ndo/tosa'nhome (single faintly attached) ❑Duplex
r rvlul family (apartment) Q Garage
ccmme mial, is it Q Sank Q Bar ❑ Church ❑ lioteVMo el 0 Medical or Ice Q U( icz Q Reait
L! Re3Laurailt Q Omer (explain)
j is ris building 50 years of age or more? Cl Yes n No If yes, You maynaed toCorllaCtTli toriCPreseruarJcn
_; hi, is tar a demGIRIOn permit What year was the building constructed?
i i' -ar�or R7 ",975 •vou W/1 need 3n a5Oesios a-lues5ment to suLll lit it £his aopGcaubn•
of
�5
fawn sprinklerJhaci�roty Urevent3r; must list licensed plumber. IT lrs� trine A/C, Must list licensed rel
S_'bcontrecors: UsY-n=came=nyi,2,Wo, Ciiroj�F-Co1/ins/IceA;7q
Plumber Mtr.'hanlCa!
---- —--------- �ooszr 2-• t 5 --- ot;,er
i=by acknowledge that: have read fnU application and state that the above Information is complete and corr�ct. i agree to
01"n?My V,'Mr. all mqur,-ements contained herein and city ordinances and state laws regulating bui}ding cons'u uctron. =know that a
3':rnit is not valid until if. has been paid and issued.
A:,zplies rf; _
a'rintiVanre:.-1 TrL �Signature