HomeMy WebLinkAbout345 Peyton Dr - Applications/Reroof - 07/26/2018City of Planning, Development, & Transportation Services
Fort 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 M 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 # &It6b(0:07- Date July 26, 2018
For office use only
Job Site Address (required) Value of Construction (labor, materials, profit)
345 Peyton Drive $5980.00
Property Owner Name Address Gty/State Zip Phone
Christopher Baker -Carr 345 Peyton Drive, Fort Collins, CO 80525 970-631-3138
Applicant Name Address City/State Zip Phone
Roof Link - IkeJon Nissen 1822 Quarter Lane Berthoud, CO 80513 480-589-3355
Contractor Address Gty/State Zip Phone
Same as Appplicant
Contractor Gty 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 9KNo
R2524
Is this a residential or commercial project? ® Residential ❑ Commercial
If residential, is it: ® 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 ® No Ifyes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
Description of work Tear down to dPrkinq and r -roof with .lasc IV C:PrtaInTAAd NnrthgatP shingles Ice and wate
shield used. Installed per manufactures high wind specs. 1 story. Licensed contractor performing work with own
employees. z% •
If lawn sprinkler/ backflow prevent er, must list licensed plumber. I f first-time A/ C, must list iiiVensed electrician.
Subcontractors: List the company name or Q'ty of Ft Collins license #
Bectrician Plumber . Mechanical Roofer 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.
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Applicant: N4 Verified by PDFfiller I
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Print Name: IkeJon Nissen Signature %r------------bate 7/96/9n1R
Revision date 2r.12017