HomeMy WebLinkAbout3430 Camelot Dr - Applications/Reroof - 08/18/2017From: Denali Roofing Fax: (970) 660-4417
To: Fax: (970) 224.6134 Page 2 of 2 08116/2017 10:00 AM
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port Collins
Planning, Development & Transportation
LVl IV. \.Vllcyc mvc r.w. UV4 JVV
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 ❑ Lawn Sprinkler ❑ Mobile Home replacement ElRoofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable informati1onn]of (n�the lication.
ti
Application # 11 v —lv
For office use only
Incomplete applica 'ons,Yv(li not be accepted.
Date 1I ]V(j 1
Job Site Address (required)
Value of Construction (labor, materials, profit)
3430 Camelot Drive
6000
Property Owner Name Address
City/State Zip
Phone
Jenn and Jared West 3430 Camelot
Drive Fort Collins CO 80525
970-222-0628
Applicant Name Address
City/State Zip
Phone
Denali Roofing, LLC 2310 E 13th ST.
Loveland/CO 80537
970-660-4417
Contractor Address
City/State Zip
Phone
Denali Roofing, LLC 2310 E 13th St.
Loveland/CO 80537
970-660-4417
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
IN Here ❑ Report
Sales tar numba-is required by all contractors
Are you paying with your trust account?
13 Yes ❑ No
49209
Is this a residential or commercial project? ❑ Residential ❑ Commercial
If residential, is it: 91 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 ❑rNo Ifyes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
If prior to 1975, you wi11 need an asbestos assessment to submit with this application.
Description of work
*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 R2111+ 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: � 8/16/17
Print Name: Katrina Fenzi Signature v` t/ Date