HomeMy WebLinkAbout401 Uranus St - Applications/Reroof - 08/03/2018Aug 03 18 10:56a Severe Weather Roofing
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F.6City, of Planning, Development, & Transportation Services
���� Community Development & Neighborhood Services
281 North College Avenue .
Fort Collins, CO 80524 . Main: 970.416.2740 Fax: 970.224.6134
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 ❑ Wood/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 # R 1j8 D (b .8 0I Date
far offixe use only
Job Site Address (required) _ Value of Construction (labor, materials, profit)
Property Owner Name Address City/State Zip Phone lit
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Applicant Name Address 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? Here ❑!Report
sales tax mmber isrwuvedb allcontractots Are you paying with your trust account? ❑ Yes PrNo
Is this a residential or c mmercU project? Residential O Commercial
If residential, is it: MSingie Family Detached ❑ Condo/townhome (single family attad-ted) ❑ 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 ❑ No Ifyes, you may need to contact H/stoHrPreservaiion
If this is for a demolition permit, what year was the building constructed?
Description of work �(� ' �.� � sr. �i4✓✓ i � . �) S ;h�.' ` ! .i 5,1M,d 51K.-
Sri°/ �•;/i' V`�. i" -'s//n lr7 -�i ,�-i lr' i1- �� -l-r• %tint. /�i Mr 7�., /-1 rj, .
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*If lawn sprinkler/backtiow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: Ust the company name or C/ty of Ft Collins license #
Electrician Plumtmr MechanicaL. Roofer. 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.
Appltcant:
Print Name: Signature Date
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