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HomeMy WebLinkAbout2757 County Fair Ln - Applications/Reroof - 04/14/20150 Planning, Davei®pmentt & Tjrensp0irWtji0n 281 N. College Ave P.O. Box 580 Fort Collins, CO 80524 Phone 970-416-2740 Fax 224-6134 'VER=THE©00UNTER PERMIT'S ONLY This application is to be used to apply for the following perMfts only (check all that apply). ❑ Air Conditioning ❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log 0 Heating Unit ❑ Lawn Sprinkler 0 Mobile Home replacement A Roofing ❑ Sewer Line ❑ Photo -voltaic ❑ Ventilation ❑ water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and manufacturer). Complete Ipli1abfie�--idoir iatioon on the applicatiioon. incomplete applications will not be accepted. Application VL Date '� ForOfice use only v -- an , ®� Sft Addfi 9 (required) Value of Consg—ucctiion(labor, materials, profit) Property Owner Name Address veST IJ%aS�C.�h`��}-5c4bcss%c,avyvr,,� city/state 5 PhoneGa�o) Appricant Name Address City/State Zip Phone /ii9 /i n C1 Contractor �9 >aj �'� ?!nU Address City/State Zip Phone dt/inAa Contractor City of FL Collins Sales Tax # Are you paying taxes here or by report? R`Here ❑ Report Sa/estarnumber&mgz redbyah'm„tracwin Are you paying with your trust account? XYes oNo Is this a residential or commercial project? ential ® Commercial If residential, is it: Single Family Detached ondo/tawnhome (single family attached) Duplex �� Multifamily (apartment) Garage If commercial, is it: Q Bank ® Bar ® Church ❑ Hotal/Motel ®Medical office ❑ Office ❑ Retail ® Restaurant ® Other (explain) Is this building Se years of agra or more? ❑ Yes 9140 ifyer, you mayneed m mntaCtHiSWTICPIWervatlon If this is for a demolli ion permit, what year was the building 09TUded? Ifpnar to 1975 you will nerd an asbestos arsesQr p„rro sub,,,�r,a,;d, bvsappOcabdn. work .o..�. =w 111� /, Ljujuw preventer, must list licensed plumber. If first-time A/C, must list licensed electrician. Slgh001111%ctota: ListGhe company name or aty of col/ins 1%WSe # Electrician Plumber Medtanlcdl Roofer495 Other I hereby acknowledge that r 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 thElt a: Pennit is n®i He'aOO un0l R has been paid and is -cued. Applicant. yL Fate Ipi'q