HomeMy WebLinkAbout901 Arbor Ave - Applications/Reroof - 11/24/2014From Affordable Roofing Inc 1.970.207.0289 Mon Nov 24 16:06:14 2014 MST Page 2 of 2
amity of Planning, Development & Transportation
281 N. College Ave P.O. Box 580
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®&t Fort.Colllns, CO 80524
Phone 970=416-2740 Fax 224-6134
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®VET ® —T YE-�®YNTER. PE/1971�� ONE
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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. 17 Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA'certiiied, provide make, model and
manufacturer) -
Complete all applicable information on the application. Incomplete applications will not be accepted..
Application # Date
For office use only
Job Site Address (fequlreo Value of Construction (labor, materials, profit)
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Property Owner Name Address City/State Zip Phone
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Address City/state 21p Phone cl-70
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Contractor _ Address /State Zip Phone
Contractor City of Ft Collins Sales Tax. #
Sties bw numberismgvkadby all mnaactors Are you paying with your trust account? IO(Yes ❑ No
Is this a residential or commercial project? WResidential ❑ Commercial
Ti residential, is It: 21FI-Single Family Detached, ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
if commerdai, Is it.. ❑ Bank ❑ Bar ❑ Church ❑ Hote.VMotel ❑ Medical office ❑ Office .❑ Retail
❑ Restaurant O Other (explain)
Is this building 50 years of age or more? ❑ Yes ❑ No Ifyes you maynsedto cvntactHlstodc Pre.ervau'on
tf this is for a demolition permit, what year was the hufiding constructed?_
If pi for to 1575, you will need air -asbestos assessment to wbmft with this appl/catloa
Descript on of work r � i P 5,
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If lawn sprinkler/backbw preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: Ust the company name or G'ty of Ft Ca!/ins/iccnsz,d
Electrician Plumber. M2[11aM¢I RDofer Q-'��5� Other„-
I hereby acknowledge that I have read this application and state that the above information is complete and correct. I agree to
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comply with all requirements co=1ned 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
Print Name Signature