Loading...
HomeMy WebLinkAbout803 Alta Vista St - Applications/Reroof - 07/17/2018City of Planning, Development, & Transportation Services Flirt 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 ❑ Roofing ❑ 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 # fJ � �u �) � V :)' Date 77 . 1-1 1 W For office use only Job Site Address (required) Value of Construction (labor, materials, profit) 4r-e0V 1,15 Property Owner Name Address City/State Zip Phone A - C&kVS Cm ROSZC00-3 - l 2 Applicant Name Address City/State Zip Phone 3�51,2k -C It Contractor Address City/State Zip Phone —20 c�of 6- - cown �f - S2S Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? ❑ Here ❑ Report sales tax number is required by all contractors. Are you paying with your trust account? ❑ Yes ❑ No Is this a residential or commercial project? WResidential ❑ Commercial If residential, is it: ❑ Single Family Detached ❑ Condo/t single family attached) El Duplex ❑ Multifamily (apartment) ❑ Garage If commercial, is it: El Bank ❑ Bar ❑ Church ❑ Hotel/Moe 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? Description of work o V TPkYoA 9,b©,�- 2 Otyd *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 R2- (O 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: `-_ \` Print Name: ?FW1 ` Dt� Signature "y Datey Revision date 2/6/2017