HomeMy WebLinkAbout1401 W Vine Dr - Applications/Reroof - 09/13/2018•T
City of Planning, Development, & Transportation Services
r /t Collins Community Development & Neighborhood Services
281 North College Avenue
Fort Collins, CO 80524 Main: 970.416.2740 Fax: 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 ❑x 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 # V � �1 � off-- Date
For office use only
9/13/2018
Job Site Address (required) Value of Construction (labor, materials, profit)
1401 West Vine Street Fort Collins, CO 80521 50,000.00
Property Owner Name Address City/State Zip Phone
Peggy Chistiansen 1401 West Vine street Fort Collins CO 80521 970-482-1620
Applicant Name Address City/State Zip Phone
Steve Arends 2643 Midpoint Dr. Unit F Fort Collins, CO 80525 970-797-2502
Contractor Address City/State Zip Phone
Assurance Contractors 2643 Midpoint Dr. Unit F Fort Collins/CO 80525 970-797-2502
Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? ❑ Here ❑ Report
sales tax number is required by all contractors. Are you paying with your trust account? WOYes ❑ No
Is this a residential or commercial project? ❑ Residential ® Commercial
If residential, is it: ❑ 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 building constructed?
Description of work Re -Roof: Complete tear -off to decking and re -roof according to manufacturers specifications
Squares: 101.99
Stories: 1 Shingles: Malarkey Vista Class A
*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 3199-R SUP 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: Steve Arends Signature n Date 9/13/2018
Revision date 216/2017