HomeMy WebLinkAbout237 N Sherwood St - Applications/Reroof - 05/06/2019 (2)�OI-t CO��If�S Planning, Development, & TranspQrtati n Servl ces
M Community Development & Neighborhood Services
281 North College Avenue
Fort Collins, CO 80524 Main: 070,416.27 0 Fax 9 rO.224.8134
OVER-THE-COUNTER PERMITS ONLY
This application is to a used to apply for the following permits only ❑ Demolition (interior n n-structural) ❑ Electrical Alteration (not se c change) alOtGas L hat ar gMer❑❑ Ai
Log
aning
❑ Heating Unit ❑ La n Sprinkler ❑ Mobile Home replacement `Roofing ❑ S�wer Lin CI Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA ertified,� provide make, model and
manufacturer).
Complete all applicable Information on the application. Incomplete applicatlo 's will not be accel ted.
Application #"rofflce-glulce lu dqA�� Date
nly
E3obE�Jk
ireld)
ValueofConsCltiOn (labor, materias, profit)
S -t3
Address
City/State Zip Phone
Applicant Name Address City/State
Zip Phone
is o S 6. S -10. 9
t`
Contractor Address S+e 2.01 City/State S
Zip Phone
2.S a-t o
Contractor City of Ft. Col ins Sales Tax # S:-e 20 t Are you ~% ? t B.
Sales taxnumberisrequiredb altconbactors y Paying taxes here or by rep ro 14lere ❑ Report
Are you paying with your truacco nt? ❑ Yes
%No
Is this a residential or m ercial project? esidentlal ❑Commercial
If residential, is tt;SI gle Family Detached ❑ Condo/townhome (single family att Iched) ❑Duplex
❑ Mt Itifamily (apartment) �Ige If commercial, is it; ❑ B k ❑ Bar ❑ Church d Hotel/Motel ❑ Medigl office ElH
0 R urant ❑Other (expan) liOffice 0 Retail
Is this building 50 years o age or more? ❑ yes I0 Ifyes, you may need to contactHlsfottid preservaHop
If this Is for a demolition ermit, what year was Che building constructed?
Description of work
1
*If lawn sprinkler/backflow p venter, must list licensed plumber. If first-time A/C, must list licee sed electrician.
Subcontractors: Ust the co npany name or aty of Ft Co!/Ms license
Electrician
—�_ Plumber 1
Mechanical_ Roofer p Other_
I hereby acknowledge that I have read this appllcatlon andr state that the above informatio
comply with all requirements ntained herein and city ordinances and state la s r ula cdmplete nd correct, I agree to
permit Is not valid until it as been paid and issued. 9 uil�ing con ruction. 1 know that a
Applicant:
Print Name:
Signature Date S • 7 • 19
Da I
Revision dale 2fo)2cj7