HomeMy WebLinkAbout2244 Merlot Ct - Applications/Reroof - 04/24/2019Cityof 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. Incomplete applications will not be accepted.
Application # '�Rq ja1IID Date
For office use only
Job Site Address (required) Value of Construction (labor, materials, profit)
2244 Merlot Court Fort Collins, CO 80528 $5,573.52
Property Owner Name Address City/State Zip Phone
Robert & Judy Homburg 2244 Merlot Court Fort Collins, CO 80528 (970) 223-3751
Applicant Name Address City/State Zip Phone
Steve Arends 2643 Midpoint Or Unit F Fort Collins, CO 80525 970-797-2502
Contractor Address City/State Zip Phone
Assurance Contractors 2643 Midpoint Dr Unit F Fort Collins, CO 80525 970-797-2502
Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? ❑ Here ❑ Report
Sales tax number isrequired byall contractors. Are you paying with your trust account? ❑ Yes ❑ No
50030
Is this a residential or commercial project? ® Residential ❑ Commercial
If residential, is it: 0 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 mayneed to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
Description of work Re -Roof: Complete tear -off and re -roof according to manufacturers specifications
SQ's: 19 // Shingle to be Install is a class 4 impact resistant shingle - Owens Corning Duration Storm
Stories: 2
*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 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: Steve Arends Signature n Date, 4/23/19
Revision date 2/6/2017