HomeMy WebLinkAbout333 Bannock St - Applications/Reroof - 09/24/2018281 North College Avenue v.�.
Fort Collins. CO 80524 Main: 970.4162740 Fax 970224.6134
OVER -TIME -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 0 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 # ic� -3"Ca 3(0(0 Date 1 Z �j li Y
For cfike rise only
Job Site AddAddriRs Gaga/red Value ofConstruction (labor, materials, Profit)
S� r
Property Owner Name�j A Address City/State Zlp Phone
r i' AC- ? ^'-e v '-611C ,11 1 its 3)b &171
Applicant Na a Address City/State Zip Phone
Contractor Address City/Stake ; Zip Phone
C- ` }are C-,S 3
Contractor City of Ft Collins Sales Tax # Are you paying taxes here or by report? Here ❑ Report
531Wrmrnumteresfagv: edbya7mntrarm1s Are you paying with your trust aocount?�-p Yes ❑ No
Is this a residential or al project? dentist ❑ Commercial
If residential, Is It: com ngle Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it ❑ Bank ❑ Bar ❑ Church ❑ HotwMotel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age ormore? ❑ Yes O No Ifyes, you imyneed to cont mtHsta&PtiL�blon
If this is for a demolition permit, what year was the building constructed?
Description of work (aS Kx.-A- -F-
*If lawn spridder/baddlow preventer, must Ilst licensed plumber. If first-time A/C, must list licensed electrician.
Subcontaactorw.Wffiecompany name orCtyofftCofflnsL'me 9
SectiWan Plumber Medmital 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 slate laws regulating building construction. I know that a
permit is not valid sntlf It has been paid and Laws&
Applicant: T
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