HomeMy WebLinkAbout904 Camelot Ct - Applications/Reroof - 09/12/2017City of Planning, Development, & Transportation Services
Fort 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 9 Roofing ❑ 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 # 8 zM �5Ytt(D Date MOM a /� i7
For ofFce use only
Job Site Address (req red) Value of Construction (labor, materials, profit)
904 O6 Camelot Ct 10,100.00
Property Owner Nam Address City/State Zip Phone
Brian Williams 904 Camelot Ct. Fort Collins Colorado 80525 970-226-5600
Applicant Name Address City/State Zip Phone
Paul Donaghey 435 Mountain Avenue Berthoud Colorado 805413 720-434-5714
Contractor Address City/State Zip Phone
Quality Renovations & Home services 4345 Mountain Avenue Berthoud Colorado 80513 970-344-5284
Contractor City of Ft. Collins Sales Tax # Are you paying, taxes here or by report? ❑ Here ❑ Report
sales tax number is required by all contractors. Are you paying with your trust account? ❑ Yes ❑ No
00132887
Is this a residential or commercial project? esidential ElCommercial
R
If residential, is it: ❑ Single Family Detach d ❑ 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 M No If yes, you may need to contactHistoric Preservation
If this is for a demolition permit, what year was the building constructed?
Description of work Remove & replace roofing.
'e
*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 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: 8/30/17
Print Name: Paul Donaghey Signature i Date
Revision date 2/62017