HomeMy WebLinkAbout2524 Charolais Dr - Applications/Reroof - 01/05/2018City of Planning, Development & Transportation
I 281 N. College Ave P.O. Box 580
For1- t Collins Fort Collins, CO 80524
Phone 970-416-2740 Fax 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 serveiF 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 # [J �0 0_0 I � �) Date
For office use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
2524 Charolais Dr Fort Collins, CO 80526
$11,050
Property Owner Name . Address
City/State Zip
Phone
James Lee 2524 Charolais Dr
Fort Collins, CO 80526
970-556-9067
Applicant Name Address
City/State Zip
Phone
Alex Krumrai 1600 Specht Pt Rd ST 101 Fort Collins, CO 80525
(970) 224-4042
Contractor Address
City/State Zip
Phone
American Dream Home Improvement 3040 S Finley Rd, Ste #200 Downers Grove, IL 60515
877-266-8666
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
2fJ Here ❑ Report
5alestax number isrequiredbyall contractors.
Are you paying with your trust account?
❑ Yes KI No
00134440
Is this a residential or commercial project? IN Residential ❑ Commercial
If residential, is it: 6 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 KI No If yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
If pnor to 1975, you will need an asbestos assessment to submit with this application.
Description of work Re -Roof 26 squaresofowens corning oakride shingles. Single layer removal, one story,
single family dwelling. Check main structure
*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 ANM Roofing 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: Alex Krumrai
Print Name: Signature 'r Date 12/28/17