HomeMy WebLinkAbout3002 W Elizabeth St - Applications/Reroof - 08/08/2018 (23)Cityoi Planning, Development, & Transportation Services
Fort Collins Community Development & Neighborhood Services
261 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 0 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 # jr' Date 08/08/18
For office use only
Sob Site Address (required) Value of Construction (labor, materials, profit)
3002 W Elizabeth St Building 12 Garage, Fort Collins, CO 80521 $4 125
Property Owner Name Address City/State Zip Phone
o saddle Rid a of Fort Collins Merged Association 115 Riverside Ave Fort Collins 80524 970-224-9134
Applicant Name Address City/State Zip Phone
Zara Collins 2015 S Pontiac Way Denver 80224 303-507-6044
Contractor Address City/State Zip Phone
Premier Roofing 3201 E Mulberry St Suite B Fort Colllns 80524 303-356-6751
Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? la Here ❑ Report
Sales tax number Isrequ/nadbyall awtacXws: Are you paying with your trust account? ❑ Yes 2 No
R-2189
Is this a residential or commercial project? 0 Residential ❑ Commercial
If residential, is it: ❑ Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) 12 Garage 1 Story
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Offlce ❑ Retail Building
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes Ig No If yes, you may need to contact Historicfreservadon
If this Is for a demolition permit, what year was the building constructed?
Description of work _Residential re -roof using 15 squares of GAF Armorshield II IR shingle
*If lawn sprinkler/baddlow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: list the company name orGty of Ft Collins 1/tense #
Electrician Plumber Mechanical Roofer Ardon Roofing 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 PI e:,e Signature Date
Revislon dale 2AM17