HomeMy WebLinkAbout4812 Langdale Ct - Applications/Reroof - 02/02/2018Ciof
Fort Collins
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Planning, Development & Transportation
281 N. College Ave P.O. Box 580
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 service change) ❑ Gas Lighter 0 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 #y o 0 o0- " 1 (P Date 2/02/2018
For ofce use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
4812 Langdale Ct
$3,133 00
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Property Owner Name
Address City/State Zip
Phone
Pedro Engel
4812 Langdale Ct Ft Collins, CO 80526
970-226-4496
Applicant Name
Address City/State Zip
Phone
Josh Lovejoy
3307 S College Ave Ste 220 Fort Collins, CO 80526
970-223-2455
Contractor
Address City/State Zip
Il Phone
Severe Weather Roofing
3307 S College Ave Ste 220 Fort Collins, CO 80526
970-223-2455
Contractor City of Ft Collins Sales Tax # Are you paying taxes here or by report?
IN Here ❑ Report
Sales tar number is required by all contractors
Are you paying with your trust account?
❑ Yes ❑ No
Is this a residential or commercial project? ® Residential ❑ Commercial
If residential, is it- ED 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 ®No If yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the budding constructed?
If prior to 1975, you will need an asbestos assessment to submit with this application.
Description of work Remove 31.33 squares asphalt shingles to decking install 31.33 squares new asphalt shingles to code
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
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Subcontractors: List the company name or City of Ft Collins license #
Electrician Plumber Mechanical Roofer Top + 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:
Print Name: Josh Lovejoy Signature
Date ii 2/02/2018