HomeMy WebLinkAbout1355 Cherry St - Applications/Reroof - 04/06/2015Rpr 06 2015 2:02PM HP LRSERJET FRX 1970-267-9005
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City, f Planning, Development&Transportation
ty O281 N. College Ave P.O.•i;ox 580
Fort Collins IS Fort Collins, CO 80524
Phone 970-416-2740 Pax 224-6134
OVER-THE-COUNTER PERMITS ONLY
This application is to be utied 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 13 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 bef accepted.
Application # T� I 5t?- . Date y-10- L5
' Far of ke we only
lob Site Address (r 0ped)
Value of Construction (labor, materials, profit)
property owner Name Address
City/State ZIP Phone
1
r 310-5a5
Applicant Name 14 Address
City/State Zip Phone
Po Box 1326
Ft. Collins 60522 9705661884
ctor Address
City/State Zip Phone
Tiros Roofing Inc Po Box 1326
Ft. Collins 80522 9705661884
Contractor City of R. Collins Sales Tax #
Are you paying taxes here or by report? M Here ❑ Report
_Wes &rnierAwjrregL*WbyaYwn&actom
Are you paying with your trust account? ❑ Yes 0010
R-1686
Is this a residential or commercial project? M Residential ❑ Commercial
If residential, is It: M Single Family Detached
la Condo/townhome (single family attached) ❑ Duplex
l] Multifamily (apartment)
l] Garage
If commercial, is it: O Bank O Bar ❑ Church
O Hotel/Motel O Medical office ❑ Office 0 Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? M Yes
O No If yes, you may need to contact Hlstorfc Preservation
If this Is for a demolition permit, what year was the building constructed?
Ifprior to 1975, you will need an asbestos assessment to submit with this ap#Ircahbn.
of work Tear off to decking & replace w/ asphalt shingles provide required vents
*If lawn Winkler/backnow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or City of Ft CoNns &-ense #
Electidan-... Plumber Mechanical Rwer R-1686 Other
I hereby edmowledge that I have read this application and state that the above inrormation Is complete and correct. I agree to
comply with ail requirements contained herein and city ordinances and state laws regulating building construction. I know thata
permit Is not valid until it has been paid and issued.
Applicant: /1 Date q-10- �7
Print Name( 4 n» Slynatu _