HomeMy WebLinkAbout3302 Snowbrush Ct - Applications/Reroof - 09/27/2018a (e-6
cl t�' °' Planning, Development, & Transportation Services
t CO��Ii1S Community Development & Neighborhood Services
281 North College Avenue
Fort Collins, CO 80524 Mein: 970.416,2740 Fax: 970.224.61$4
OVER-THE-COUNTER PE MITS ONLY
This application is to be used to apply for the following permits o check all that apply). ❑ Air Conditionin ❑ Demolition (interior non-structural) ❑ Electrical Alteration (not serv' a change) ❑ Gas Lighter ❑ Gas Log g
❑ 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 #- U ctlo "N OO-1-- Date
For office use only
]ob Site Address (required) Value of Construction (labor, materials, profit)
Property Owner Name Address City/State Zip Phone
l %' t .
A ` \
Applicant lV ` e ' 1. r Address City/State Zip Phone
Address CiVtate Zip Phone
Contractor City of F4 Collins Sales Tax # V _ ' ' ` i
. Are you paying taxes here or by report? ❑ Here ❑ Report
sales tax number isreguiredbyall contractom Are you paying with your trust account? ❑ Yes ❑ No
Is this a residential or coercial project? residential El Commercial
If residential, is it: VSingle 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(expla'
Is this building 50 years of age or more? ❑ Yes o Ifyes, you mayneed to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
Description 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 collins license #
Electrician Plumber
Mechanical 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 construction. I know that a
permit is not valid until it has been paid and issued. ,--_
Applicant:
Print Name:_DaN\ QA&I
Date D ffikl
Revision dale 2/6/2017