HomeMy WebLinkAbout956 Ridge Runner Run - Applications/Reroof - 04/04/2019Fob zowii5 Planning, Development, & Transportation Services
Community Development & Neighborhood Services
281 North College Avenue
Fort Collins, CO 80524 Main: 970.416,2740 Fax 970,224.6134.
OVER-THE-COUNTER PERMITS ONL
This application Is to be used to apply for the following permits on ly (check ❑ Demolition (interior n n-structural) ❑ Electrical Alteration (not se Chang ) al❑ Gas l that L
❑ Heating Unit ❑ Lan Sprinkler Cl Mobile Home replacement `.Roofing ❑ Sewer Lin
❑ Ventilation ❑Water reater ❑ Water Line ❑ Wcod/Pellet
manufacturer). Stove (must be EPA certified
Complete all applicable information on the application. Incomplete applications will n
Application # q V
fbroffrc agony Date
Sob Site Address
Property Owner Name
Ply). ❑ Air Conditioning
3hter ❑ Gas Log
❑ Photo -voltaic
provide make, model and
A be accepted.
0?® e�
value of construction (labor, materials, profit)
lForf/'o/lin � D A05�4 �R / ni b4'
Address CRY/State
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Applicant Name Address D�r. Gty/State
. S 66 zip
Contractor 1c± enitat
Address S+e- Z•oi
Qty/State Zip
25
Contractor City of Ft Cold"ns Sales Tax # 5w- 2 0 % V
Sales&rnamberitregalredby�a0m>r Are You Paying taxes here or by rep
Are you paying with your trust accol
Is this a residential or m ercial project? Residential ❑ Commercial
If residential, is it: sh igle Family Detached ❑ Condo/townhome (single family attached)
If cammeraal, is it: ❑ MI Ike ❑Y (apartment) ❑ Qrage
(1 Bar ❑ Church ❑ Hotef/Motel ❑ Medical office ❑Office t
❑ Restaurant ❑ ether (explain)
Is this building So years o age or more? ❑Yes
If this is for a demolition Y XNo fixes, YOU maYneed to carrtactHistnrii rmlt, what Year was the building constructed?
Description of work
C
*If lawn sprinlder/backfiaw p reventer, must list licensed plumber. If first-time A/C, must fist lice
Subcontractors: L&MemrWPd nYnameor01YOfRCoNnsrcenw 0
' Electrioan----- III
Plumber Mechanical � Refer QooFt
[Permit
ereby adamwledge that I ave read this application and state that the above infonnatio
mply with ail requirements ntained herein and city ordinances and state I s wmg co h
is not valid until it s been paid and issued. regula g hiding mmplicant:rint Name: d
Signature
Datc
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Phone 1
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Phone
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Phone
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t? I CHere ❑ Report
t? ❑ Yes )KNo
❑ Dupleh
Retail
'n�ervadon _
1G1TS' �"0
rsed electrician.
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e.�— Other.
id correct I agree to
.ruction. I know that a