HomeMy WebLinkAbout3100 Stanford Rd - Applications/Reroof - 10/07/2014From Affordable Roofing Inc 1.970.207.0289 Tue Oct 7 14:12:36 2014 MST Page 6 of 17
Q" o¢ Planning, Development &Transportation
Fort CoRins 281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
U1i�R-THE- ' Ugh" ER PERMITS ONLY
This application Is to be used to apply for the following permits only (check ail that apply). 0 Air Conditioning
❑ Demolition (interior non-structural) ElElectrical Alteration (not service change) 13 Gas Lighter ❑ Gas Log
❑. Heating Unit ❑ Lawn Sprinkler C7 Mobile Home replacement 0 Roofing Q Sewer line 11 Photo -voltaic
❑ Ventilation ❑ Water Heater I] 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.
Appilcatfon # For atn-ce use nry use n�}-1 . Date
Value of Construction (labor, materials, profit)
Property Owner Name Address City/state Zip
d
Phone C170
4UPPrV 2650 9U-W,41and .fir C-0. g.o50
AApplicant Name Address City/state Zip
•
Phone ch U
c) a l-1 w , ti ci T=
2( -7-oU0
Contractor Address /state Zip
Phone
Contractor City of Ft. Collins Sales. i ax
Salaslay nu WrIsregofredbyzllcontractors Are you paying with your trust account? [dyes
❑ No
Is this a residential or commercial project? ,A'Residentlal Q Commercial
>l iresidential, is.it: -)WSingle Family Detached ❑ Condo/tDwnhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
if commercial, is it ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medica[ office ❑ Office 0 Retail
11 Restaurant ❑ Other (explain)
is this building 5o years of age or more? ❑. Yes ❑ No If yes, you Mayneedto Cont3&H/storfePreservaiYo17
]f this is for a demolition permit, what year was the building constructed?
If prlor io 1975, you will need an asbesros assessment to submit with this app/Icatfon.
DescriplJon of work ar on -k-- 'Cr-F,' O
A`
r
vie 5
'If lawn sprinkieribackfiow preventer, must Ust licensed plumbier. If first-time A/C, must list licensed electrician.
Subcontractors:"St fhecompanynameorOtyofFtCalinS&ense
EeCridan Plumber Mechanical Roofer —} 5 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 c[iy ordinances and state laws regulating building construction. I know that ,a
pe"nitis not valid until it has been paid and issued.
Applicant.,
Print Marne: 1 Signature