HomeMy WebLinkAbout2625 Brookwood Dr - Applications/Reroof - 11/15/2018FCity of Planning, Development, & Transportation Services
it Collins 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 inRoofing ❑ 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 # 1 J V✓�0 ��
For ofte use only
Date 11/15/18
Job Site Address (required) Value of Construction (labor, materials, profit)
2625 Brookwood Dr, Ft Collins CO 80525 $4,000
Property Owner Name Address City/State Zip80525 Phone
Linda Dibble 2625 Brookwood Dr Ft Collins 970-219-9280
Applicant Name Address City/State Zip Phone
Contractor Address City/state Zip Phone
On Target Roofing 5210 Coral Burst Cir, Loveland CO 80538 970-619-8902
Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? E6 Here ❑ Report
Sales iaxnumber isre illredbyallmnbactom Are you paying with your trust account? 10 Yes ❑ No
Is this a residential or commercial project? ® Residential ❑ Commercial
If residential, is it: 9 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 If yes, you may need to conta&H6toric Pfeservatlon
If this is for a demolition permit, what year was the building constructed?
Description of work Tear off and reroof 20sauares to code Install premium class 3 shingle -
Malarkey Vista
*If lawn sprinkler/baddiow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List bbe company name or City of Ft Collins Abar se #
Electrician Plumber Mechanical Roofer Red Canyon 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., AIaX Millsa
Print Name: Alex Millsap Signature p Date 11/15/18
R.vA.i. dab ZaWl7