HomeMy WebLinkAbout3125 Meadowlark Ave - Applications/Reroof - 07/10/2015From Affordable Roofing Inc 1.970.207.0289 Fri Jul 10 12:16:56 2015 MDT Page 2 of 2
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Planning, tieveiopment & Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970-416-2710 Fax 2Z4-613=:
This application is to be used to apply for the following permits only (check all that apply), Cl Air Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) 0 Gas Lighter 0 Gus Log
Q Llesbng Unit 0 Lawn Sprinkler Cl 10obile Hume repiacenent ❑ Roofing ❑ Sewc-r Line 0 Photo -voltaic
0 Ventilefton 0 Water Heater 0 Water Lins Cl bVoodlPeil=_t Stove (must be EPA ceril9ied, provide make, mods! and
manuiacurer?.
Comolets all applicable la7formation on the application. incomplete appiioations will not be aocepteei.
loplica�lon = Dare
fbrorrce use only
:lob Site Address (rerufmd) Value of Construction (tabor, materials, profit)
Prooery owner Name Address City/state Zip Phone (( j
�pplir rr`_nrne Address city/state Zip Phone q-7C� '
n1b,A tLC T-IT Ft� �.-_...�(J -ova(I
ant �r 3 Address'.y?State Zip Piiane f
i
i
LOntractw City of, Ft. Collins Sales Tax
zs c hum =ris re?uiad by all rani ectom Are you paying with your trust account? Yes 0 P40
is cries a residential or commercial project? -Avitesidentici LJ Commercial
fl csiuenfial,I _ it; Single Family Detached ❑ Condo/te:anhome (single i, mlly attached) C Duplex
iwlultifamiiy (apartment) ❑ Garage
is eamnlertial, is it ❑ Bank Bar 0 Church ❑ Hate-1/Motel 0 Medical am, ce ❑ Office 0 Retail
Restaurant C. Other (explain) ,
s tl^Ss building 60 years or age or more? G `r'es O No ry,e you maynawd to contact Historic l raservai on
i` -3s is for a demolition perrinit, what year was the building eon5vieted?
Si pr idr to 1975, you will acadi an asbestos a'ses&ynZ'77r io submit with Iwi-applica on.
of
op-
x€f tavm sprinklerlbacRlow preventer'mus; list Pcensed plumber. ltfln time A/C, must rA licensed electrician.
SudSCQntr-actors: Un' he =7r pany nacre ar Ofy of Ft CoAllw tens.- '
Eler! ician- Fllicrther M2crtanfcis Roarer -R—IR51 Other
r- heresy 5cknoWledge tbat s have read ibis application and state that the above information is complete and correct. I agr_s to -
t comply vain all requlwnents contained herein and cfiy ordinances and state laws regulating building construction. 1know that:a
aermit is not valid until it has been paid and issued.
rim name: 'Irn �f �' V�u>i r�� Sigmature ,