HomeMy WebLinkAbout1913 Ross Ct - Applications/Reroof - 12/21/2017Dec 21 2017 12:40 RTC 9707763741
page 1
r ■ birl Collii1s
This application Is to be
❑ Demolition (interior non
❑ Heating Unit ❑ Lawn
❑ Ventilation ❑ Water Fit
manufacturer).
Complete all applicable
Application #
farofmw
Planning, DevelopMer;4 & Transportation Services
Community Dev lopment & Neighborhood Services
261 North Co&ege Avetwe
Fort Collins, CO 80524 Main: 970.4162740 Fax 970.224.6134
R-THE-COUNTPR PERMITS ONLY
to apply for the following Permits only (check an that apply). ❑ Air Conditioning
lural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
Jer ❑ Mobile Home replacement '"oonng ❑ Sewer Line ❑ Photo-voltak:
❑ Water Line ❑ Wood/Pellelt Stove (must be EPA certified, provide make, model and
on the application. lacornpiste applications will not be accepted.
Date tat w I�n 11
Job Ste Address (Amp~)
Value of Construction (labor, materrals, profit)
v1-.a
Property Owner Name
Address CitylState ZIP Phone
Applicant Name
Address City/State 23p Phone
r
/
Ica 1 D OD
Conhactor
Address Cfty/State Z p Phone
iles Tax # Are you paling bees here or by report? l)jHere ❑ Report
Contractor of Ft. Collins
� �ns
�xtwx Are you paying with Your trust amount? ❑ Yes )WNo
Is this a residential or corn
1 Project? IQ ResidLential 0 Corrvnercial
If residential, Is It: 0 Single
m11y Detached Condo/bovinhome (single family attached) ❑ Duplex
Mupifa
ly (apartrrrent) Garage
If commercial, Is It: 0 Bank
Bar 0 Church 0 HoteVMottai 0 Medical office ❑ Office p Retail
❑a Ru
0 Other (explain)
Is this bulkllog 5o years of
If this Ism for a deoBtion
Or more? ❑ YesKNo Br yew maned m h Pres>grrgpon
R what year was a buildinggoo nstnrcted?
Descrl of work
lto-r r
must a Uoemsed plumber. Ifirst-time A/C, must list licensed eleetrlcian.
*If lave sprinkler/baddtow
SubcorrtraotorsrListbhe
1d
yABmeorplf'ofRC1:d//nsplum
W Medmankal � RoafsrTD-6 Ober
I hereby adamowledge that I have
comply with all requirements
sad this application and state that the above Information is complete and correct. I agree to
ed herein and city ordinances and state laws regulating building conshvch9om
permit is not valid until it has
I know tiratt a
am paid and issusd.
Applicant
print NOW.
Signature Date f'f
m mdooee■=M?