HomeMy WebLinkAbout1901 Ross Ct - Applications/Reroof - 12/19/2017 (3)Dec 19 2017 16:07 RTC 9707763741
page 2
0t y of Panning,
O� Whns
Deve/opmegt, & Transportation Services
Community Development & Neighborhood Services
261 North College Avenue
Fort Collins, Co 60524 Main: 970.416.2740 Fax: 970.224.6134
OV
R-THE-COUNTER PERMITS ONLY
This application Is to be used to
❑ Demolition (Interior non-structu
apply for the following perm only (check all that apply), ❑ Air Conditioning
I) O Electrical Alteration (not
❑ Heating Unit ❑ Lawn Sprinkler
service change) ❑ Gas Lighter ❑ Gas Log
❑ Mobile Home replacement ! POR00flng ❑ Sewer Line ❑ Photo-voltsic
❑ Ventilation L7 Water Heater ❑ 1
Voter Line ❑ Woodipallet Store (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable Informart
n on the�appikatlon. Inco+Iete applications will not be accepted,
Application # l V
�— I ate 1
i5or&7& use curly
lob Sits Address ( )
AW leools
L
alue of onstruction (labor, matalals, profit)
..m
Property Owner Name
Address
/State Zip - -Phone
Applicant Name
Address
/State ap Phone
Contractor
AddrI.Aess
tylState ZIP Phone
Contractor City of R. Collins Saps
S1A!!r!LF1rrn04IKtr MgrrraibyaN turner
Is this a residential or commercial p
If residential, Is it ❑ Single Fam
E3 Multifamily
if commercial, is It: ❑ Bank (3 B
❑ Restaurant
Is this building 50 years of age or
If this is for a demolition permW,
Description of work
Are you
Are you
❑a
Zr • -7
aranent) ❑ Garage
❑ Church ❑ Hobel/Motel
❑ Other ( lain)
re? ❑ Ye No If yes,
rt year wa the building ca
taxes here or by report? ❑ Here ❑ Report
with your trust account? ❑ Yes ❑ No
(single family attached) ❑ Dupes
Medical office ❑ office ❑ Retail
need to cwrtact HLsir & PfM eruabbn
*If lawn sprinklertbacidlow preventer, i iust 09 licensed plumber. If fl time A/C, must list Heensed electrician.
Subcontractors: Lae the caff►PwY or aty oift Coffins dcew #
Bethinan Plumber Herharncal ,
�_ Roofer �J� Other
1 hereby acknowledge that I have read Is application and state that the obove hhformation Is eomplebe and correct. I agree to
ComPIY with all requirements containedinerem and city ordinances and state laws regulating building construction. I know that a
Permit is not valid until it has been gold and band.
Applicant:
Print Name, / l signature
Date
nmsaermtt � ,