HomeMy WebLinkAbout3002 W Elizabeth St - Applications/Reroof - 08/08/2018 (13)City 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 ® 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.
6;�ll li Application # r1
For ofce use only "
Incomplete applications will not be accepted.
Date 0810018
Job Site Address (required) Value of Construction (labor, materials, profit)
3002 W Elizabeth St Building 15 Fort Collins CO 80521 $14,400
Property Owner Name Address City/State Zip Phone
e saddle Ridge 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 Collins 80524 303-356-6751
Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? la Here ❑ Report
SWestax number IsrequIredbyall conbactors Are you paying with your trust account? ❑ Yes 12 No
R-2189
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 2 Story
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail Buildin
❑ Restaurant ❑ other (explain)
Is this building SO years of age or more? ❑ Yes P No If yes, you may need to contact Hl�;aricPreservadon
If this is for a demolltlon permit, what year was the building constructed?
Description of work Residential re -roof using 70 squares of GAF Armorshield II IR shingle
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: Ust the company name orGtyofftCollins license #
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 Name:_ � JZr ii:5 Signature Date ��/20
neweton date 2M=17