HomeMy WebLinkAbout3713 Stratford Ct - Applications/Reroof - 10/01/2014Fort of
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 # 13i`ti at Date i DA / l Y
Far oAste rae only
Sob Site Address (nw& d)
Value of Construction (labor, materials, profit)
3713 Stf ,4o rd
C--L
1 '7 000
Property Owner Name
Address Gty/State
Zip Phone
GrefChen Grosz
3713 Stmi-Rord C, RCollrns Co
8056J5 970-1140-MFS
Applicant Name
Address City/State
Zip Phone
-�-ona+bco MAXfi ell
181a Rextn9t00 5& rteolitns Co
8o5a.5 3o3-y/oogsT
Contractor
Address City/State
Zip Phone
Cooker L'ofl3kGCc b/1
l Sla Rccuin!34on SE R-L'ollrn5 Co
805a5 303-7(0 -085,?
Contractor City of FL Collins Sales Tax # Are you paying taxes here or by report? X Here ❑ Report
sakvt3xnwnberismgz~byaffconba cam Are you paying with your trust account?. ❑ Yes ANo
Is this a residential or cwmmerdal project? Altesidential ❑ Commerdal
If residential, is tt 1&Single Family Detached ❑ Condo/bownhome (single family attached) ❑ Duplex
❑ Multifamiy (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hobel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 yearsof age or more? ❑ Yes )qNo If yes, you may need to contactHisftvk Preservation
If this is for a demolition permit, what year was the building constructed?
Fphor to 1975, you wi# need an asks assessment to submit w1th d* app/kad=
Description of work Ae-- I-OO ' d don 40 deck , aSPha l+- Shrng leiS,
3a s s I`y
*If lawn sprinkler/baddlow prevenier, must list licensed plumber. If first-time A/C, must list licensed electrician.
Suboontraktors: list the mmpanyname or Oty offtChA s &wAse # L 0,6o r
i]ediidan Plumber Medwnkat Roofer Eo-r I Con 5 �-- other
I hereby admowledge 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.
Print Name: Ina.ftwo I tdAel SIgnature
Date 1011V