HomeMy WebLinkAbout2157 Saison St - Applications/Reroof - 09/26/201809/26/2018 09:22 9705930124 GOLD ROOFING INC PAGE 01/02
Cityp Planning, Development, & Transportation Services
ins Community Development & Neighborhood Services
281 North College Avenue
Fort Collins, CO 80524 Main: 970A16.2740 Fax 970.224.034
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 ❑ 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 bs accepted.
Application #_ �by D r I Date 9/.2(0 // 8
For ofike use only
lob Site Address (required) Value of Construction (labor, materials, profit)
SAt'So gb3q,00
Property Owner Name Address City/State Zip 1/7 Phone
-/lot/
970-1
Applicant Name Address City/State Tip Phone
Aig (J/'% r4N-r
Contractor -r Address City/State Zip Phone
[p 1pl o7/H i 1.2il E 4EI'el' towVAGI ZeuQlaw)' co eesn
Contractor City of Collins Sales Tax # Are you paying taxes here or by report? 8 Here ❑ Report
raxrwmbff t rWu#W by all av*aa= Are you paying with your trust account? & Yes ❑ No
Is this a residential or commercial project? ® Residential ❑ Commercial
if residential, is it JR 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? O Yes f r No If yes, you may need to contact Nislvric Preservation
If this is for a demolition permit, what year was the building constructed?
Description of work -moJ ( r ilurAo t/ / l -r J59, Alcar'
*If lawn sprinkier/baddiow preventer, must list licensed plumber. IT first-time A/C, must list licensed electHdan.
Subcontractors: L& me company harm ar aty of Ft Collins license 0
Electriaan Piumber. Mechanical Roofer rpt 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.
Print tit Name: /I/ici w lC. "i r ture le Date 9�j La //J'
wrina, date 215rm17