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HomeMy WebLinkAbout6112 Southridge Greens Blvd - Applications/Reroof - 06/25/2018W�vllx wn� 5f C44-11f, znv c� Planning, Development, & Transportation Services .,Foirt Collins Community Development & Neighborhood Services W& 281 North College Avenue Fort Collins CO 80524 Main 970 416 2740 Fax 970 224 6134 OVER-THE-COUNTER PERMITS ONLY This applicatm 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 6 Roofing ❑ Sewer Line ❑ Photo -voltaic ❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified provide make model and manufacturer) Complete aN applicable Infpor�m�a�tion on the application incomplete applications vines not be accepted Application # 4 U-T `� ° Date ►� �Q 1 g For oft% use &* lob Site Address (required) ue of Con on (labor mat nals profit) 6112 Southndge Greens Blvd Fort Collins CO 80v2 Property Owner Name Address City/State ZIP Phone Brad Athn 6112 Southridge Greens Blvd Fort Colhns CO 80525 970490-8558 Applicant Name Address City/State Zip Phone Denali Roofing LLC 3780 N Garfield Ave Ste 203 Loveland CO 80538 970-660-4417 Contractor Address City/State Zip Phone Denali Roofing LLC 3780 N Garfield Ave Ste 203 Loveland CO 80537 970-660-4417 Contractor City of R Collins Sales Tans # Are you paying taxes here or by report? 0 Here 0 Report .Sales tax number is rewxed by aff Inaba cibm Are you paying with your trust account? 11,Yes ❑ No R2111+ Is this a residential or commercial project? DResidential ❑ Commercial If residential is it DSingle Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex ❑ Multifamily (apartment) ❑ Garage If commercial, is it © Bank ❑ Bar ❑ Church ❑ Hotel/MoW 0 Medical office 0 Office 0 Retail ❑ Restaurant ❑ Other (explain) is this building 50 years of age or morel ❑ Yes 0 No If yes you may need to contact Histonc Preservation If this is for a demolition permit what year was the building constructed? Descnptmn of work remove cummt roofing system down to woad deck cnstail Betator'te State Bettvrte State Starter 20 PacrMW tM Edge Ice and Water Belaforte Slate Ridge 10' Ohagen Vents Pipe Boots Will use 1 114 Cod Nads *If lawn sprinkler/badd ow preventer must list licensed plumber If first-bme A/C, must list licensed ekwtnoan Lest Me company name or Oty of ft t;.ollins license if Elecbxm Plumber Medianical Roofer&Vdll Other I hereby adviowiedge 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 budding construction I Ivww that a pennrt is not valid unt d it has been paid and issued PirName Katrina Fenzi Signature ill h t rla Fries. late June 18 2018 Rewsm Oafs 2AIM7 � % , q l[/