HomeMy WebLinkAbout3021 Stonehaven St - Applications/Reroof - 07/29/2019City of
�, ort Collins
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970-416-2740 Fax 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 serviiF change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement NAoofing ❑ 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 # b I gosh �q
For office use only
Date�'��
Job Site Address (required)
Value of Construction (labor, materials, profit)
3021 Stonehaven Dr Fort Collins, CO 80525
$13,000
Property Owner Name Address
City/State Zip
Phone
Ron Archuleta 3021 Stonehaven Dr
Fort Collins, CO 80525
970-658-6561
Applicant Name Address
City/State Zip
Phone
Alex Krumrai 1600 Specht Pt Rd ST 101 Fort Collins, CO 80525
(920) 224-4042
Contractor Address
City/State Zip
Phone
American Dream Home Improvement 3040 S Finley Rd, Ste #200 Downers Grove, IL 60515
877-266-8666
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
M Here ❑ Report
Sales tax number is required by all contractors.
Are you paying with your trust account?
❑ Yes KI No
00134440
Is this a residential or commercial project? IN Residential ❑ Commercial
If residential, is it: E) 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 KI No Ifyes, you mayneed to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
Ifpnor to 1975, you will need an asbestos assessment to submit with this application.
Description of work Re -Roof 29 squares of Class 4 Duration Storm asphalt shingles. Single layer removal, one story,
single family dwelling. Check main structure
*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 Tornado Roofin�Pther
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: Alex Krumrai
Print Name: Signature '� Date 7/26/19