HomeMy WebLinkAbout1102 Sawtooth Oak Ct - Applications/Reroof - 12/17/2014Planning, Development &Transportation
City Of 281 N. College Ave P.O. Box 580
F01 t Collins 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 # l �� Date
For office use only
Job Site Address (required)
'I�( Value of Construction (labor, materials, profit)
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Property Owner Name Address
City/State Zip
Phone
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A plicantfName Address City/State Zip
Phone
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Contractor Address ity/State Zip
Phone
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Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report? p Mere ❑ R port
Sales tax number isrequired byall rontractors
Are you paying with your trust account❑
Yeso
Is this a residential or commercial project? Residential ❑ Commercial
If residential, is it:ingle Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
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 J2rNo Ifyes, you mayneed to contact HistoiicPreservation
If this is for a demolition permit, what year was he building constructed?
If prior to 1975, you will need an asbestos assessment to submit with this application.
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*If lawn sprinkler/backflow preveiter, must list licensed plumber. If first-time A/C, rr(ust 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: z _
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Date
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