HomeMy WebLinkAbout2618 Raintree Dr - Applications/Reroof - 04/16/2015Planning, Development 8c Transportation
®�� �®����� 281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
OVEWTH&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 .9 Roofing ❑ Sewer Line ❑ Photo -voltaic d
❑ Ventilation
manufacturer).
❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model an
Complete all applicable information on theapplication.
Application # f,��
Fnr''ofRce use OD/V
incomplete applications will not be accepted.
Date
Is this a residential or commercial project? ❑ Residential ❑ Commercial
If residential, is it: ❑ Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
IM Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑Office ❑Retail
❑ Restaurant ❑ Other (explain)
Is this building 5o years of age or more? ❑ Yes 13 No If yes, you may need to contact Histmic Preservadon
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 appllcation.
Description of work ks_64c � r, 2�0 �� � �I r s ,, Co- Aq ,, ,,,� �. � �
G -W
91
*If lawn sprinkler/backi'low preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or Cty of Ft Col/ins 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 wame: fA�cti c SignatureAj� Date