HomeMy WebLinkAbout903 Stover St - Applications/Reroof - 02/27/2017From Affordable Roofing Inc 1.970.207.0289 Fri Feb 24 11:44:17 2017 MST Page 2 of 2
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970•416-2740 Fax 224-6134
OVER-THE-COUNTER PERMS ONLY
this application is to be used to apply for the following permits only (check all that apply). O Air Conditioning
Cl Demolition (interior non•structurap ❑ Electrlcal Alteration (not service change) Q Gas Lighter O Gas Log
❑ Hearing Unit ❑ Lawn Sprinkler G Mobile Home raplac eman; ❑ Roofing ❑ Sewer Line ❑ Photo-voltak
a Ventilation 0 skater Heeler ❑ Wpmr Line O tMoodn'ellet Sbve (must be EPA certified, provide make, model and
manufacfureo.
Complete all applicable Informetlon on the application. Incompltite applications will not be acceoted.
Appllcatlon # brq-ooegq� Jaffe
t-rWke use anA'
300 Site Address; lreor I value of Constructlon (labor, mamius, prom)
Property Owner Name Address
Zip Phone
Appllont Name Address Gty; Slate Zip Phone q 7�j
r� rcic %Zoo�r u
i.cnta-ar TAddress .Y/51ata ZIP Piton
Contractor City of R. rallins Sales Tax d
>Nft rdrrxeitwis madrad byaf cawaatrr_.
Are you paying with your trust a¢aunt? 'A Yes ❑ No
Ts this a residential or cumme dal Projea? _'Pegtlentlal ❑ Commerdal
It reildenttal, is IC .$Single Family Detached ❑ Condo%wnhame (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commertial, Lit ❑ Bank ❑ Bar ❑ Churdi ❑ Ilottd/Motel 0 Medical atrtoe ❑ Office ❑ Retail
Q Restaurant ❑ Other (explain)
is this building 30 years of age or more? ❑ Yes ❑ No If^ ;mrr may rased to orrhdct H15mrt pr25arv3Ptyr
If this is Far a demolition parmiC what year was the building constructed? _
if 00r ro 1973, YW wRr need en asbE=s asmssmerrr ao submit swirl Mis oparcidrvr. '
De piion ofwdic 17far o P-2 . rxplo ct -exis�;r,�,�45]Q��
Ck1vT al Wit•itQOtf:1 t'Tryk YYhsi hs-I—CS_•)
i" Ef farm spdnideribacmm preventer, must Bet ficensed plumber. if ivc:•iime A/C, mug: us Bceroee tl_Ctri[mn. � I
SYbCo"C'tbM 14W die Compagy eWMVa G'ty aft[ CWWS ken=: I
llaC7tdi,L-_ �Rnber Mfthw*4 ItWtr.R—U 59 Omer i
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I he: eby e[lmowledge brat i hove read this P.pVkauw. aced state that the above Odor: gallon is mmpiere ano Correct I agree to ,
01'* with all repubeulerts f n fined hendn and cQy ordinances and state lava regulating building consinwton. I know that e
permit is not valid until It has been paid and Icsuad.
Applicant /�// i
Print Name:.. S .t�C srgnatum _ �-�i-e^--Vffir Qi Z iLJ i ( 1