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HomeMy WebLinkAbout3024 Ross Dr - Applications/Reroof - 06/21/201606/14/2016 09:39 19702241211 CkyaF F Cotti s This appfiestlon is to be used ❑ Demolition (Interior non-struc ❑ Heating Unit ❑ Lawn SpdnN ❑ Ventilation ❑ Water Heater manufacturer). Complete all applicable Infom Application # `b l 100- ror&WM ROCKY MTN ROOFERS PAGE 01/01 Planning, Oeveiopmetnt fk 7lraansportation 281 N. College Ave P.O. Box 580 Fort Collins, OD 80524 Phone 970-416-2740 Fax 224-6134 E-COUNTER PERMITS ONLY apply Mr the !following penmits only (check all that apply). ❑ Air Conditioning al) ❑ EIWMc al Alteration (not service change) ❑ Gas Lighter ❑ Gas Log r ❑ Mobile Home replacement XjRoofing ❑ Sewer Line ❑ Photo --voltaic Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and n on the application: Incontplete applications will not be accepted. 96 Date a� lob She Address (faqui ) Value of Con on. (labor, matMals, proms) -ZLD14'-Rass-L�,V� 500D, c3c�' Property Owner Name Address City/State Zip Phone App cant Dame Address city/State zip Milne Contractor #* -R -t-+9r 3 Address city/State Zip PhoneR-ja R%'r.V-hA w.t&:1-& : JOCX € 0ti'ANames . � . l am Contractor Ctty of FL Collins Sale; Tax * 1413 Va Are you paying taxes here or by report? ❑ Here lit Report se �rrwinberis byasB Are you paying with your trust account? 40 Yes ❑ No Is this a residential or corn ial reject? N Residential O Commercial If residendal, is It: ❑ Single Fa fly Detached ❑ Condo/townhome (single family attached) U Duplex b�Muttifami Eapar er) 13 Garage If commercial, is it: U Bank © r ©Church O FloteVMabe! O Medtcai affioe O t]fFice ❑Retail 13 Restaura ❑ Other (explain) Oft is building 50 years of age o more? I7 Yes E No Byes, you mayneeid to av?fvctH/ CPhewwbbn if this is for a demolition pe what year was the building constructed? �JQ JFpfiw to 1975, ww wi// need an azesswent to avtmk "0 flbfs ag0i(ita&w. Description of *If lawn sprinkler/baddiow prevents Subeotttrttebara: L& the cwnWny I hereby admowledge that t have comply with all requirements offal permit is not valid until it has Applicant: Print Name:_ 0_ mast Ust licensed plumber. If nrstttme A(C, must NA licensed electrician. vue 4rO?yofF`CbllmsI if YNV c► t.e.-n f t-� L-IJ—' Medcanicai Roofer Other this application and slate that the above information' is complete and correecL I agree to heroin and city ordinances and state laws regulating bullding construction. It know that a i paid and Issued. .. ti Signature l» L-14.z�t-o