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HomeMy WebLinkAbout1026 Trading Post Rd - Applications/Reroof - 06/22/201606/22/2016 17:18 9705930124 GOLD ROOFING INC PAGE 01/01 City of Planning, Development & Transportation 281 N. College Ave P.O. Box 580 6rt Collins 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), D Air Conditioning ❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log O Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement oofing ❑ 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 #� �_� (� ��� • pate For office use only Sob Site Address (mquIred) Value of Construction (labor, materials, profit) Property Owner /Name Address ��ZG �! %r City/ to / Zip Phone 070 �� ��C( Lf d z'6 r..r i�0 rh o D S l — nt Name Address MR7-'A City/State Zip phone %�7G>r� G6T Contractor L «t Address /� City/State /� Zip Phone dz lr.�%.S AY�WX (J(,ICJ fvS y P [ 2- —xmv Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report?MYere ❑ Report Sales taxnumber&wulred by all contraclnr� Are you paying with your trust account?eS ❑ NO Is this a. residential or commercial project? ' residential ❑ Commercial If residential, is it: .2'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? [7 Yes ,9-ro' If yes, you may need to conta&Historic Preseniat/on If this is for a demolition permit, what year was the building constructed? 0prlor to .1975, you will need an asbestos assessment to submit wlffi this applimtlon, of work — Q E ski . e N 5 1 D le -4- Zy s *If lawn sprinkler/backflow preventer, must list licensed (plumber. If first-time A/C, must list licensed electrician. Subcontracbors: List the company name or Cldy offs Collins license # Electrician Plumber MechanicalRoofer 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: Print Name• / 7- d"(o e.�S '� Signature _ 1 paw Z� ��