HomeMy WebLinkAbout3507 Stratton Dr - Applications/Reroof - 05/21/2015May 2915 04:41 p
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r Coffins
Planning, Development &Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
OVER-THE-COUNTER PERMITS ONLY
This appli tion is to be used to apply for the following permits only (check all that apply). ❑ Air Conditioning
❑ Demolit n (interior non-structural) ❑ Electrical Alteration (not servlce change) ❑ Gas Lighter. ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventiiatic n ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
Complete 11 applicable information on the application. Incomplete applications will not be accepted.
Applicati ieo `"T �a4 Date S/'21z 701S�
For office use only
Job Site
dress (required)
Value of Construction (labor, materials, profit)
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Property Owner
Name j Address
City/StateZip
Phone
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Applicant P
ame Address
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City/state Zip
Phone
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Contractor
Address
City/State Zip
Phone
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Contractor
City of Ft. Collins Sales Tax#
Are you paying taxes here or by report?
El Here ❑ Report
9a1estax nu
berrsrequiredbyallcontractors.
Are you paying with your trust account?
XYes ❑ No
A1021;y
Is this a r idential or commercial project? 0 Residential ❑ Commercial
If residents 31, is it: j95ingle 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 buili fing 50 years of age or more? ❑ Yes A No If yes, you may need to contact Historic Preservatfon
If this is f a demolition permit, what year was the building constructed?
Irpnor to 975, you will need an asbestos assessment to submit with this application.
Descripti
n of work 6YA6V6 sus sh'>1
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*If lawn sl
rinkler/backnow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontr
ctors: List the company name or G'ty of Ft Collins license #
Electrician
Plumber Mechanical Roofer � Other
I hereby afknowledge that I have read this application and state that the above information is complete and correct. I agree to
comply wi 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. /J
Applican : lyfj
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