HomeMy WebLinkAbout302 Snowy Owl Cir - Applications/Reroof - 08/21/2018/ FCity of Planning, Development, &
®rt CoRins Community Development
281 North College Avenue
Fort Collins, CO 80524 Main:
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Transportation Services
& Neighborhood Services
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). 0 Air Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler 0 Mobile Home replacement ❑ ❑ Ventilation ❑Water Heater ❑ )(Roofing ❑ Sewer Line Photo -voltaic
manufacturer). Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
Complete all applicable information on the application. Incomplete an 1i ,
Application #_ IZ) E�j�-(Z j
For office use only
Address
Address
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M Address
p a Ions will not be accepted.
Date<31 2l', 7
Value of Construction (labor, materials, profit)
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City/state Zip i
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City/State Zip , Phone
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City/State Zip Phone
Are you paying Taxes here or by report? ❑ Here ❑ Report
Are you paying with your trust account? ❑ Yes A No
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Is this a residential or commercial project? 'Residential El 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 -"-yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was 1� building constructed?
Job Site Address (requirec
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Property Owner Name
Applicant Name
Contractor
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Contractor City of Ft. Collins
les Tax #
Wes tax number is required by all contractors
of work
*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//ins license #
Electrician
� Plumber
Mechanical
Roofer&V&rGIab 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:
Revislan data 2IM017