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HomeMy WebLinkAbout1026 W Oak St - Applications/Reroof - 08/01/2018®P-CollinsPlanning, Devel�r�sFa ent, & TPanspo;�fion Setreces - Community Development & Neighborhood Services • 281 North College Avenue Fort Collins. CO 80524 Main: 970.416,2740 Far: 970.224.6134 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 ❑ Gas Log ❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement O Roofing 0 Sewer Line O Photo -voltaic 0 Ventilation ❑ Water Heater ❑ Water Line ❑ WOod/Pellet Stove (must be EPA certified, provide make, model and manufacturer). Complete all applicable innfonination on the application. Incomplete appliccat tons will not be accepted. Application #y V �$--7� Date o For 01rice'use only --. Job Site Address (rnqulmd) Value of Construction (labor, materials, profit) 0 w ©e'-r Zor} �oill � OS:�) I t -4i % -T Property Owner Name Address City/State Zip Phone applicant Name IAddress City/State Zip Phone Contractor Address City/State Zip Phone Cf f c tIC227S.t k< u. d r•, JV,7,2 Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? ere ❑ Report Saks eaxnumberlsrrgarredbyall kanbatror Are you paying with your trust account? ?laces ❑ No Is this a residential or commercial project? i5Wesidential ❑ Commercial If residentiatils it: -,,?Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex /E Multifamily (apartment) ❑ Garage If commercial, is it: ❑ Bank ❑ Bar ❑ Church 0 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 con&xrHlstaricPreservatlon If this is for a demolition permit, what year was the building constructed? Description of work w oe '1•� 1 t'v%t�S *If lawn spdnkier/baddiow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician. Subcontractors: List the mmpanynameoratyori,16rb1lins/icrnm�' Electrician Plumber Medianical Roofer 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 ranstrucrion. I know that a permit is not valid until it has been paid and issued. 1 Print Name- &=Ir rt' Signature- r_ !G pan c Rmn .aaio�17 • ✓