HomeMy WebLinkAbout4675 Venturi Ln - Applications/Reroof - 10/20/2015Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
OVENmTHE-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 E3 Gas Log
❑ Heating Unit 13 Lawn Sprinkler ❑ Mobile Home replacement 17 Roofing O Sewer Line ❑ Photo -voltaic
• Ventilation 0 Water Heater O Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
manufactyrer).
Complete; ati applicable information on the application. Incomplete applications will not be accepted.
Application # 31507 SS 7 Date
For office use only
lob Site Aridness (required).
Value of Construction (labor, materials, profit)
Property Owner me
Address
City/State Zip
Phone
. ram
i
a L�
Applicant dame
Address
City/State Tip
Phone
Contractor;
Address
City/State Zip
Phone .
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ContracboriCity of Ft. Collins Tax #
Are you paying taxes here or by report? ere
❑ R rt
%51W tax numbs- isrequired byall =&acmrs.
Are you paying with your trust a000unt? E3 Yes
Is this a residentiaIMTiulngie
al project? ' `fesidential ❑ Commercial
If residential, is it: Family Detached ❑Condo/townhome (single family attached)Duplex
ltifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar 0 Church ❑ Hotel/Motel 0 Medical office 0 Office i7 Retail
0 Restaurant ❑ Other (explain)
Is this building 50 years of age or more? 0 Yes U No If yes, you may need to cautc&HistodcPraservation
If this is fora demolition permit, what year was the building construcbed?
ifprior to 1975, you MI/need an asbestos assessment to submit wib°i dais app/lcatmn.
of work
*If lawn sprinkler/baddiow preventer, must list'licensed plumb& —.If first-time' A/C, must list licensed ek&dan.
subconbaetors: List Me company name or Gty of ft Collins license #
Sect ician Plumber Mechanical Roofer Other
I hereby adgi owledge 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.
P nr�ne I UU 1 `F Le nature