HomeMy WebLinkAbout3401 Sun Disk Ct - Applications/Reroof - 10/17/2017,Fcity Planning, Development, & Tirans ortatlon Sertfices
ort Collins Community Development & Neighborhood Services
281 North College Avenue
Fort Collins, CO 80524 Main: 970.416.2740 Farc 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 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 # b ` 1D VC0J W Date
For office use only
lob Site Address (repuired) Value of Construction (labor, materials, profit)
U ( SL>n C-f J
Property Owner Name Address City/State Zip Phone
C.hr�67 e o n . Ed, _ c5 74 -4136
Applicant Name Address City/State Zip Phone
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3VF
Contractor Address City/State Zip Phone
' —�S .. G 7C
LyyC6 LC'-LI, o Contractor City of Ft Collins Sales Tax # Are you paying taxes here or by report? 1�(Here ❑ Report
sates tax number19mqu ad by aumneacto,x Are you paying with your trust account? XYes ❑ No
Is this a residential or commercial project? llResidential ❑ Commercial
If residential, is it A] 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 O No If yes, you may need to contact lAstonc, presewtron
If this is for a demolition permit, what year was the building constructed?
Dtripton of work�Qt-Y,ca;c -4- �i�le��C S a ci- � Sl�� f Sh•
*If lawn sprinkler/baddlow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or Gty of Ft Collins /Icense #
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 '
Print Name. Signature
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