HomeMy WebLinkAbout2943 Rams Ln - Applications/Reroof - 11/12/2018Clty of Planning, Development & Transportation
Fort
281 N.!College Ave P.O. Box 580
Collins Fort Collins, CO 80524
Phone i 70-416-2740 Fax 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 Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer). i
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application # e-) NO 99 Date J- ,
For office use only
Job Site Address (required) Value of Construction (labor, materials, profit
Pro erty Owner Name �IAddrfess/
City/State Zip
Phone
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Applicant Name Address
City/State Zip
Phone
Contractor Lic # 11� )�i', Address
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City/State Zip
Phone COO
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UL1\L 7-TL Cu '52=—�zy
2Z-'A-1Z_' 0
Contractor City of Ft. Collins Sales Tax # L J
Are you paying taxes here or by report? ❑ Here jQ Report
SalesW number is required byall contractors .
Are you paying with your trust account? 9 Yes
❑ No
Is this a residential or commercial project? `*esidential ❑ Commercial
If residential, is it: ❑ Single Family Detached Condo/townhome (single family attached) ❑ Duplex
ElMultifamily (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 contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
If prior to 1975, you will need an asbestos assessment to submit with this application.
Descr' tion of workti
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JL'
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*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C� must list licensed el ctrician.
Subcontractors: List the company name or City of Ft Collins license # (;11 r 2e .Zd L�/
Electrician Plumber Mechanical Roofer Other
I
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: g ��< ��.
Print Name; JiSignature Date
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