HomeMy WebLinkAbout2003 Lookout Ln - Applications/Reroof - 06/17/2018City Of Planning, Development & Transportation
Fort Collins 281 N College Ave P O Box 580
Fort Collins CO 80524
Phone 970 416 2740 Fax 224 6134 f '
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 serveiF change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement EiAocifing ❑ Sewer Line ❑ Photo voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified provide make model and
manufacturer)
Complete all applicable i r anon on the application Incomplete applications will not be accepted
PRApplication # WW5 Date ' Zu
For office use only
Job Site Address (required)
Value of Construction (labor materials profit)
2003 Lookout Ln Fort Collins CO 80526
$13 175
Property Owner Name Address
City/State Zip
Phone
Linda Williams 2003 Lookout Ln
Fort Collins CO 80526
970 282 7858
Applicant Name Address
City/State Zip
Phone
Alex Krumrai 1600 Specht Pt Rd ST 101 Fort Collins CO 80525
(920) 224-4042
Contractor Address
City/State Zip
Phone
American Dream Home Improvement 3040 S Finley Rd Ste #200 Downers Grove IL 60515
877 266 8666
Contractor City of Ft Collins Sales Tax #
Are you paying taxes here or by report?
M Here ❑ Report
Sales tax number is required by all contractors
Are you paying with your trust account?
❑ Yes %I No
00134440
Is this a residential or commercial project? IN Residential ❑ Commercial
If residential is it 6 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 KI 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 wdl need an asbestos assessment to submit with this application
Description of work Re Roof 31 squares of Owens corning oakride shingles Single layer removal one story
single family dwelling Check main structure
*If lawn sprinkler/backflow preventer must list licensed plumber If first time A/C must list licensed electrician
Subcontractors List the company name or City of Ft Collins license #
Electrician Plumber Mechanical Roofer Tornado RoofinWther
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 Alex Krumrai
Print Name
Signature
OAA-- `klut4ry
Date 6/25/18