HomeMy WebLinkAbout520 N Sherwood St - Applications/Reroof - 04/22/2019 (6)Cityof 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 #hDate
For ofAce use only
Job Site Address (required) Value of Construction (labor, materials, profit)
, -o N sheJ d s-- Lin FoEai gm (A 2 $ 3�
Property Owner Name Address City/S to Zip Phone
Applicant Name Address City/State Zip Phone 303
Inc:1U`Q,L`70 6 - N' n waq Ga BLd ll2'i s 2g
Contractor Address City/State Zip Phone FZ3
-cowGVC41 70 ,6 VQAE-2
Contractor City of Ft. Collins Sales Tax # Are you paying taxes heYe or by report? Here ❑ R port
Sales tax number is required by all contractors Are you paying with your trust account? ❑ Yes 90
661 '2�1 &04S
Is this a residential or commercial project? ❑ Residential Q111fornmercial
If residential, is it: ❑ Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
Multifamily (apartment) E3 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 If yes, you may need to conlactHistoricPreservation
If this is for a demolition permit, what year was the building constructed?
Des ription of work — = 2 ' 2
- S 7&
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or Cityof Ft Collins license #
Electrician Plumber Mechanical Roofer Other
e
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: I��
Print Name: // Signature Date /,/A 12lo1q.
P.�w.M n.ia giRmI7