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HomeMy WebLinkAbout1024 Oxford Ln - Applications/Reroof - 03/24/2015 (7)03-24-'15 16:17 FROM -Premier Roofing 9704848308 T-296 P0011/0016 F-591 Flirt C®ltin s Planning, pevetoprnent e: Transportation 281 N, College Ave P.O. Box 580 Fort Collins, CO $0524 phone 976,416.2740 Fax 224.6134 T application IS OVER-THE-COUNTER apply for the f0II0WI1Wq p. �PERMITS ts only (check all aONL � Air Conditioning This applto be used a Demolition (Interior non-structural) © Electrical Alteration (not sere ce change) 13 Gas lighter 0 Gas Log G Heating Unit 0 Lawn sprinkler 0Mobile Home replacement Xltooflng 0 Sewer Line CI Photo -voltaic 13 Ventilation Cl Water Heater 13 Water Line a Wood/Pellet stove (must be EPA cartifled, provide make, model and manufacturer). Complete all applicable Information on the application. Incomplete applications will not be accepted. Application #__�._. �8 � �o�• Date 31�y__�. 1?a►-� .._..�.^— For aN9cv use Only job Site Address (Avulmd) Value of Construction (labor, materials, profit) 10 wi L9c44 %.,r .i* /Z (il /b e9 /7. to Property Owner Name Address City/State Zip Phone Al i — c: j si?O ZiN ,4 Lf 4 a fy(vr Applicant Name Address City/State Zip Phone Joshva, Wolcl�i�. Contractor Address City/state Zip Phone n D %-a. _ Su.lt g 1' Col\�v+5, t0' '8QJJ2�t 03��ti Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? Here 13 gepo rt .svlestavnumberISM0lredbyallcont'"IS' Are You paying with Your trust account? 13 Yes �o Is this a residential or commercial project? 0 Resldentlal 0 Commercial If residential, is It: 13 Single Family Detached E3 Condo/townhome (single family attached) � l7uplex )dMultifamlly (apartment) M Garage If commercial, is it: Bank O Bar ©Church 1 Hotel/Motel p Medical office [I office 13 Retail [3 Restaurant [3 Other (explain) Is this building Sill years of age or more? 0 Yes l jNo !f yes, you may need to contact Hhtoec Pressrvallon If this is for a demolition permitr what year was the building constructed? lfprlor to 1975 you will need an asbttstas assessment to submit with this applicotten. Description of work *If lawn sprinkler/baddiow preventer, must list licensed plumber. If firs"me A/c, must list ikemeo eiearPan. subcontractors: Ust the company name or cYtyvfft aad/ns nctsrrrrse a' Etec!rlclaq,�,�—.--. plumber.. __. _ -�- MarJ�mnkalr-----�'" R°°fer Other I hereby acknowledge that I have read this applic"Oon 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. Applicant: Data 3 !�`► 17pIS Print Name: ..bSY+�ir Wok—signaNrre