HomeMy WebLinkAbout701 Pear St - Applications/Reroof - 10/27/2017Fort Collins Planning, Development, & Transportation Services
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'appli). ❑ Air Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (notryryry���'ce change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑Lawn Sprinkler ❑ Mobile Home replacer Roofing ❑ Sewer Line ❑ Ph t Itai
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pe
manufacturer).
Complete all applica
ble Information on the application.
Application # I�v 123�
For ofike use only
0 o-vo c
list Stove must be EPA certified, provide make, model and
Incomplete applications will of be accepted.
Date v
lob Site A nos (requited) V I e of construction OaboT, materi ) '
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Pro rty Owner Name Address City/State Zip Phone 910
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plicant Nam Address aty/�tate Zip Phone 970
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Contra
r Address City/State Zip Phone i —70
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Contractor city of FL CWns Sales Tax # Are you paying taxes here or by report? ere ❑ Report
sqks tax nwn w is re v rd by all anrt&acrors. Are you paying with your trust acoount? es ❑ No
Is this a residential JPr mmercial project? Residential ❑ Commercial
If residential, is it: 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( ain)
Is this building 50 years of age or more? O Y No If M you may need In contact Nlstorfc Pne56va#on
If this is for a demolition permit, what year was the Oding constructed?
Desaipti n of work OV'Q Ct vd� Oa
*If lawn ri er/backflow preventer, ust I licensed plumber. If first-time A/c, must list licensed electrician,
Subcontractors: Ust Me company name or QY of Ft Collins license 0
6 Plumber mechanicaL. Roofs Other
I hereby admowledge 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 C
S
Print Name: I Signature Date I Q � 7LI
RMalm 0Me 7iBrl017
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