HomeMy WebLinkAbout518 Larkbunting Dr - Applications/Reroof - 06/30/2017Cityof Planning, Development, & Transportation Services
Fart Collins 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 XRoofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all appl/iiccable information on the application. Incomplete applications will not be accepted.
Application # ,C7 ���J(t�5.� Date 6/30/17
For office use only
Job Site Address (required) Value of Construction (labor, materials, profit)
518 Larkbunting Dr., Ft. Collins, CO 80526 $2791.50
Property Owner Name Address City/State Zip Phone
Andrew Vogt 518 Larkbunting Dr., Ft. Collins, CO 80526 970-631-9164
Applicant Name Address City/State Zip Phone
David Brostrom 3535 S. Platte River Dr., Suite G2, Sheridan, CO 80110 303-239-6633
Contractor Address City/State Zip Phone
Beyond Roofing, LLC 3535 S, Platte River Dr., Suite G2, Sheridan, CO 80110 303-239-6633
Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? X Here ❑ Report
sales tax number isrequiredbyall contractors. Are you paying with your trust account? ❑ Yes I,KNo
00135394
Is this a residential or commercial project? CZ Residential ❑ Commercial
If residential, is it: 5(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? ❑ Yes XNo If yes, you mayneed to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
Description of work Roofing repair over the garage, 1st story - 3 Squares
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or City of Ft Collins license #
Electrician Plumber Mechanical Roofer Beyond Roofing, LLC 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: APaV-eci ��d
Print Name: David Brostrom Signature Date 6/30/17
Revision date 2ro/2017