HomeMy WebLinkAbout1400 Edgewood Ct - Applications/Reroof - 04/27/2015Ciof
F®rt Collins
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 # //10)6�11 �, �✓ �l-1 Date 4/27/2015
For office use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
1400 Edgewood Ct.
1700.00
Property Owner Name Address
City/State Zip
Phone
James Wilson 1400 Edgewood Ct. Fort Collins CO 80526
970-227-3046
Applicant Name Address
City/State Zip
Phone
John Anderson PO Box 2207
Fort Collins CO 80522
970-223-2455
Contractor Address
City/State Zip
Phone
Severe Weather Roofing PO Box 2207
Fort Collins CO 80522
970-223-2455
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
Here ❑ Report
Sales tax number is required by all contractors.
Are you paying with your trust account?
❑ Yes ❑ No
50255
Is this a residential or commercial project? V Residential ❑ Commercial
If residential, is it: Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
Multifamily (apartment) ❑ Garage I
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes ❑ No If yes, you may need to contact HistmicPreservalron
If this is for a demolition permit, what year was the building constructed?
If prior to 1975, you will need an asbestos assessment to submit with this application.
Description of work Remove 17 asphalt squares to decking and replace with 17 asphalt squares to
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or City of Ft Collins license #
Electrician Plumber Mechanical Roofer
Other
I hereby acknowledge 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.
Applicant:
Print Name: John Anderson Signature
��Z'��nate 4/27/2015