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HomeMy WebLinkAbout112 N Grant Ave - Applications/Reroof - 06/10/201606/06/2016 15:57 9703539774 I PAGE 01/01 Planning, Development ill. Transportation C� 281 N. College Ave P.O. Box 580 �olN `uns 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 17 Lawn Sprinkler W�ter Line Home ❑ Wood/Pellet Stove (must be EPA certif'Roofing C3 Sewer Ledeprovidein❑Photo-voltaic makemodel and ❑ Ventilation ❑Water Heater ❑ manufacturer). plication. Incomplete applications will not be accapted. Complete all applicable information on the ap Application #, For oftJce use only lob site Address (required) Date —lame 8 2018 U Id_ 1 p Value of Construction (labor, materials, profit) property Owner Name Address City/State Zip Phone Same Ft. Collins 80525 Applicant Name A Address city/State Zip Phone 970-391 Tim Kramer Address City/State Zip Phone Contractor _ Iflut:4401l Contractor City of Ft~ Collins Sales Tax # Are you paying taxes here or by report? ® Here 17 Repo rt Are you paying with your trust account? Yes Sales tax number is Irquired hyall contred Ofs 13 No is this a residential or commercial project? ® Residential 13 Commercial ©Duplex If residential, is It: (2 Single Family Detached ❑ Condo/townhome (single family attached) 0 Multifamily (apartment) 0 Garage If commercial, Is it: ❑ Bank 13 Bar ❑ Church 13 Hotel/Motel ❑ Medical office ❑ office Q Retail ❑ Restaurant ❑ Other (explain) Is this building So'years of age or more? ❑ Yes C[No if yes, you may need to contact Historic Preservation If this Is for a demollt➢on permit, what year was the building constructed? .tlr"prior to t975, you will need an asbestos assessment to subm/t with th/s application. Description of work Tear off to deck, install drip edge ice guard at eaves 30 lb. felt valley tin *If lawn sprinkler/badcFlow preventer, must list licensee piumoer. Subcontractors; Ust the company name or City Of Collins l/cense # Electrician Plumber. A/C, must list licensed electrician. EX- aA 0C) Mechanical Roofer R- 94 _ 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: al. j�ra,yylpy R 9[]16 Print Name: Tim Kramer _ signature Date Jtio' - -