HomeMy WebLinkAbout5968 Snowy Plover Pl - Applications/Reroof - 07/26/2019��: Planning, Development, & Transportation Services
F6k Collins Community Development & Neighborhood Services
_ 281 North College Avenue -
Fort Collins. CO 80524 Main: 970.416.2740 Fax 970.224.6134
Al
OVEWTHE-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 Lftoofing , ❑ 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 # 1 t ® 5—VA 4 Date:
For of/rice use only
Job Site Address (required)
property owner Name Address
licant Name Address
_ ..n oon y i
Contractord Address
Contractor City of Ft. Collin ales Tax # -
saks lax number is required by all cnntracmrs,
Value of -Construction (labor, materials, prnfiit)
City/State Zip Phone
4 c. r °I jo-) I y
City/State Zip G Phone
�L c o ' '
i �13Sd S 67bl� -3 W
City/State ZipPhone
Are you paying taxes-hereor by report? 911 ❑ Report
Are you paying with your trust account? ❑ Yes ❑ No
is this a residential or commercial p ect? Residential ❑ Commercial' . _ '- ❑.Duplex
If residential, is it: ❑ Single Family Detached 0 Condo/townhome (single family
attached)
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church 0 Hotel/Motel ❑ Medical office ❑ Office ❑ Retail -
❑ Restaurant ❑ Other (explain)
If
Is this building So years of age or more? O Yes ❑ No yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
Description of work Ike -(Do E
*If lawn sprinider/bacldlow preventer, must list licensed plumber. If first-time A/C, Must IM licensed eleeiTitian.
Subcontractors: List the company name or Crty of Collins license # %7 III i f . _ , , . _.. _-
8ectriaan
Plumber Mechanical Koorer'�
I hereby acimowledge 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.
r UApplicant: I �. Date 11
Print Name: +� Srgn
Revision data M=17