HomeMy WebLinkAbout1508 W Mountain Ave - Applications/Reroof - 09/07/2018. City of Planning, Development, & Transportation Services
/^� dhns 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 goofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicaauseonly
n on the application
Application #0I
For office
Incomplete applications will not be accepted.
Date
Job Site Address (required) Value of Construction (labor, materials, profit)
1600 \v.►1.ttl4t_�'ciN� }��'e FVI'i-(Dill i,LU �'�� ( �i i_( 'L.:'' C-IC-L?Z-2�'C2
Property Owner Name Address City/State Zip Phone
1-1L,.C7
Applicant Name Address City/State Zip Phone
Majestic Roofing LLC 6200 N. Garfield Ave Loveland Co 80538 970-667-8500
Contractor Address City/State Zip Phone
Ma estic Roofing LLC 6200 N. Garfield Ave Loveland Co 80538 970-667-8500
Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? R Here ❑ Report
Sales tax number is required by all contactors. Are you paying with your trust account? M Yes ❑ No
Is this a residential or commercial project? IN Residential ❑ Commercial
If residential, is it: IN 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 Q 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 _ Remove and Replace Shingles Y2-'}t✓I'i (U�tC , G S��I ttL1'
1 1/4 Coil Nails 6 per Shingle S. o'_l
1
*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 co/tins license #
Electrician Plumber Mechanical Roofer R-1510 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 Nam
�C((C�I1l?iCy1 Signature L�`tC��.L"`1^ Date
Revision dM Z15=17