HomeMy WebLinkAbout3101 San Luis St - Applications/Reroof - 07/23/2019°T Planning., Development,d Transportation Services
��� Community Development& Neighborhood Services
281 North College Avenue .
Fort Collfns,'CO 80524 Main: 970.dl6.2740 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) d Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler q Mobile Home replacement R Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line Q 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 # (�/nll Date i-a3-1G
For office use only
Job Site Adders ()requ ) Villue of Construction (labor, materials, profit)
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Property Owner Name Address City/state Zip Phone
gstn avi\t �,Ce1\ rs i105as 0-aly-1?0)
Applicant Name Address city/state ZIP Phone
Majestic Roofing LLC 6200 N. Garfield Ave Loveland Co 80538 970-667-8500
Contractor Address City/State %p Phone
Majestic Roofing I LC 6200 N. Garfield Ave Loveland Co 80538 970-667-8500
Contactor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? IR Here ❑ Report
Sales tax numberisrequMedbya11=17tacmrs Are you paying with your trust account? ® Yes D No
Is this a residential or commercial project? IN Residential ❑ Commercial
If residential, is it: ® 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
Q Restaurant ❑ Other (explain)
is this building 50 years of age, or more? ❑ Yes Q No Ifyes, ynu mayneed to contaaHfsfarlc PYesenrattion
If this is for a demolition permit, what year was the building constructed?
Desr—Hptlon of work Remove and Replace Shingles Orr� I
1 1/4 Coil Neils a par Shingle
*If lawn sprinkler/backaow preventer, must list licensed plumber. If firsfi time A/C, must list licensed electrician.
5ubmntz clmrs: List the company name or City of Ft ccllinslieense 0
Elecv?cian Plumber Mechanical Roofer R-1510 other
I hereby acknowledge that I have read this application and state that the above inrvrmation is complete and correct, I agree to
comply with ail requirements contained herein and city ordinances and state laws regulating building construction. I known that a
permit is not valid until it has been paid and issued,
Signature � , Date
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