HomeMy WebLinkAbout825 Rocky Mountain Way - Applications/Reroof - 12/07/2017City 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
PLEASE CALL FOR PAYMENT
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 serve a change) ❑Gas Lighter ❑Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement Woofing ❑ 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 # l JI-1 v< �-5 Date 12/7/17
For office use only
Job Site Address (required) Value of Construction (labor, materials, profit)
825 Rocky Mountain Way Fort Collins, CO 80526 $2500
Property Owner Name Address City/State Zip Phone
Douglas Himmelberg 825 Rocky Mountain Way Fort Collins, CO 80526 970-556-4028
Applicant Name Address City/State Zip Phone
Carly Fronsee 3307 South College Ave. #220 Fort Collins, CO 80525 970-223-2455
Contractor Address City/State Zip Phone
Severe Weather Roofing 3307 So. College Ave. #220 Fort Collins, CO 80525 970-223-2455
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 VNo
R-2152
Is this a residential or commercial project? 4T Residential ❑ Commercial
If residential, is it: 19Single 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 \reNo If yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
Description Of work Remove 25 sq. to decking on main dwelling and detached shed & replace w/ 24 sq. Owens Corning Duration Teak.
Install drip edge, ice/water shield, new metals, and new vents. Detach and reset gutters. Tarp perimeter. 1 Story. 4/12 Pitch.
*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 Top and Bottom 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: Carly Fronsee ��// r
Print Name: Signature (gal -IL / %rly.E Date 7217/7
Revision date 2/6/2017