HomeMy WebLinkAbout1330 Tarryton Dr - Applications/Reroof - 08/24/2015c vof
%rt CoWns
Planning, Development U Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
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 ❑ Wood/Pellet Stove (must be EPA certi d, provide make, model and
manufacturer).
Complete all applicable information on the application. Incomplete appl!9otion will n/e accepted.
Application # B 1 5 V C9 3 SCE Date
For office use only
Job Site Address (required)
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Value of Co �struc ion (labor,
aterials, roft)
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Property Owner Name Address
City/State Zip
Phone
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Applicant Name Address
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City/State Zip
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'Phone
Contractor Address
City/State Zip
Phone
Contract r City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
(Mere ❑ Report
Sales tax number is required by allcontractorm
Are you paying with your trust account?
❑ Yes 11�%
Is this a residential or commercial project? E!r-Residential ❑ Commercial
If residential, is it: 41: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 o If yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
Ifprior to 1975, you will need an asbestos assessment to submit with this application.
Description of work
*If lawn sprinkler/back-flow
e.
must list licensed plumber. If first-time A/c, m
licensed electrician.
Subcontractors: List the company name or City of Ft Collins license 0,
Electrician Plumber Mechanical Roofer yZ4�0 Other
I hereby acknowledge that I have read this application and state that the above information is complete and correct. I agrF
comply with all requirements contained herein and city ordinances anc�tat� laws regulating building construction. I,knowt a
permit is not valid until it has been paid and issued. /1 / I
Applicant: � V Q� iI/`� 'gnature / Date Name: /, / I