HomeMy WebLinkAbout1924 Ross Ct - Applications/Reroof - 12/19/2017 (4)Dec 19 2017 17:34 RTC 9707763741
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F°y`f A Planning, Develop en4 & Transportation Services
Q W1111S Community Devel5pment & Neighborhood Services
281 North College Avenue
Fort Collins, CO W524 Main: 970.416.2740 Fax 970.224.6134
THE -COUNTER PERMITS ONLY
This application Is to be us to apply for the following rmlte only (check all that apply). ❑ Air Conditioning
❑ Demolition (Interior non- rat) ❑ Electrical Alteretion ( of service change) ❑ Gas Ughter ❑ Gas Log
❑ Heating Unit ❑ Lawn Spti kler ❑ Mobile Home replacem *ooftng ❑ Sewer Line ❑ Photoaroftelc
O Ventilation ❑ Water H ❑ Water Line ❑ Wood/Pel Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable i on on the application. Incomplete applications will not be accepted.
Application # i Date 141!5 aot^1
�e
lob Ste Address (mqubad)
Value of Conatnrcdw (labor, materials, protira
i
Property Owner Name
Address
City/state Zap Phone
q
aC3-a -
Appflcant Name
Address
City/State Zip Phone
E t
3-3 t0D
Contractor
Address
as Tax # Are)
City/state Zip Phone
i
ou paying taxes here or by report? A10Here ❑ Report
City of R. Collins
nrLrAllgr tya#
Are
ou paying with your trust account? ❑ Yes
Is this a residential or commerd
If residential, is It: C Single
I project? ^0 Reftntlal13 1Ibmmerdal
ly Detached Condo
me (file family attached) C1 Duplex
0 Muitifa
If commercial, is It 13 Bank
ty (apartment) ll]] Garage
Bar ❑ Churdn 0 Hots/ m
1 O Medical office O Office 0 Retail
❑ Restau
❑ Other (explain)
Is this btdldhg So years of
If this is for a denatltibn
or more] D Yes !r
P. what year was the building
yov mu— m Wn=h pp mn
a
nstructed?
Descripilim of work
w
Abe
OF
ter, must Not licensed plumber. It
V law sprknkiwMdddf w pr
first-time A/C, must Rd ltoenset! elecatirlden.
9ubcontactorw Lkttlre
MmfnleorC7'ryafRChWhs floarmg
Elecrden PIu
Mad= IML
Other
I hereby admowledge that I fnave
comply with all requirements cDm
Ved this WOkxtimr and state Ow
hed herein and city ordinances
the above information is om►plete and eon+ect I agree to
Permit b not valid untll It has
a
Wen paid and bawd.
state laws regulating buildN construction. I knm that a
Apollo
Print Name:*q*L
darn re jf4
Date
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