HomeMy WebLinkAbout3406 Stratton Dr - Applications/Reroof - 06/09/2015Jun 09 1510:39a Tony
1-970-669-5999 p.5
sty/ of Planning, Development & Transportation
} 281 N. College Ave P.O. Box 580
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�E Cottdi s 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 0 Gas Log
0 Heating Unit 0 Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
0 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 # 2215 0 L41 Li'
For office use only
Datel
Job Site Address (required)
Value of Construction (labor, materials, profit)
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Property Owner Name
Address
City/State Zip "0 -YSq- HOP
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Applicant Name
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Address
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City/State Zip Phone
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Contractor
Address
City/State Zip Phone
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N. bryol!qAve. jp�-Love-4
Contractor City of R. Collins Sales T
sa14gstax number tsmquiredbyall cantractors
Are you paying with your trust account? ees 17 No
Is this a residential or commercial project? 'Residential ❑ Commercial
If residential, is it: kSingle Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank L7 Bar ❑ Church ❑ Hotel/Motel ❑ Medical office O Office ❑ Retail
0 Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes O No If yes, you may need to contact Hmwic Preservation
If this is for a demolition permit, what year was the building constructed?
Ifpnor to 1975, you will need an a5bestns assessment to submit with this application.
Of
*If lawn sprinkierlbacidlow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: Ust the company name or (3ty of ft Coffins rcense #
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
i comply with ail 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: i
(Print Name: Stgna Date U