HomeMy WebLinkAbout3806 Arctic Fox Dr - Applications/Reroof - 12/18/2014O{ Planning, Development &Transportation
City
I 1 281 N. College Ave P.O. Box 580
Fort Collins Fort Collins, CO80524
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 a I I that apply). ❑, Air Conditioning
O Demolition (interior non-structural) ❑ Electrical Alteration (Pot service change) ❑ Gas Lighter ❑ Gas Log
O 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 # bIL4 I 6L�)3_7 Date
For office use only
Job Site Address (required) Value of Construction (labor, materials, profit)
Property Owner Name Address City/State I Zip , I Phone
Applicant Name Address City/State Zip Phone
Contractor Address City/State Zip Phone
CAPITOL ROOFING INC. 6540 5, COLLEGE FORT COLLINS 80526 970-223-5500
Contractor City of Ft. Collins Sales Tax k Are you paying taxes here or by report? �K Here ❑ Report
sales rarnumterisrequiredby allcontractors. Are you paying with your trust account? ❑ Yes R`10
s this a residential or commercial project? C Resideritial ❑ Commercial
If residential, is it: MSingle Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail f
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes qlNo /fyes, you may need to contact Historic Preservation
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.
if lawn sprinkler/backllow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or Ci(y 0/Ft Col/ins license a
-�lv�S wIr_-Dorie�_
Eleancian Plumber Mechanical Rooter Other
I hereby acknowledge that I have read this application and state that the above information is complete and correct. I agree to i
comply with all reouirements contained herein and city ordinances an;zv
g construction. I know that a i
permit is not valid until It has been paid and issued.
i
Applicant:
Print Name: CAPITOL ROOFING INC Signature Date -_