HomeMy WebLinkAbout642 Brewer Dr - Applications/Reroof - 06/23/2015From: Denali Roofing Fax: (970) 660-4417 To: 19702246134
Fax: +19702246134 Page 1 of 1 06232015 3:06 PM
'City of
Fri Collins
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 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 ❑ VVood/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 #1 �c� `'t�� `� Date
For office use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
642 Brewer Drive
Property Owner Name Address
City/State Zip
Phone
All Property Services! Rachael 642 Brewer Drive Fort Collins, CO 80524
Applicant Name Address
City/State Zip
Phone
Denali Roofing, LLC 2310 E 13th ST.
Loveland/CO 80537
970-660-4417
Contractor Address
City/State Zip
Phone
Denali Roofing, LLC 2310 E 13th St.
Loveland/CO 80537
970-660-4417
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
® Here ❑ Report
sales tax number is requiredby all contractors
Are you paying with your trust account?
IlYes ❑ No
49209
Is this a residential or commercial project? ❑ Residential ❑ Commercial
If residential, is it: El Single 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 LTNo If yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
Ifpnor to 1975, you will need an asbestos assessment to submit with this application.
Description Of work Remove old roofing system down todeck. Install synthetic underlayment over entire surface. Install ice
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or City of Ft Collins license #
Electrician Plumber Mechanical Roofer R2111+ 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:
Print Name: Katrina Fenzi Signature U Date 6/23/2015