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HomeMy WebLinkAbout1800 Angelo Ct - Applications/Reroof - 07/29/2019City of Planning, Development, & Transportation Services Fort Collins Community Development & Neighborhood Services ' 281 North College Avenue Fort Collins. CO 80524 Main: 970.416.2740 Fax: 970.224.613a 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 QrRoofing ❑ Sewer Line ❑ Photo -voltaic ❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and manufacturer). Complete all applicable nnfrr information on the application. Incomplete applications will not be accepted. Application # Y) \ ` S on`-� K Date rl /-)A / /I For office use only Job Site Address (required) L' (required) Value of Construcon (gbor, materials, profit) Property Owner Name Address City/State Zip Phone obA AIL.N GotA '/6,3 9wAlini6-P,J f r e. 57-S 70 7-zz 57 Applicant Name Address City/State Zip Phone 6U-S 'JD 1+AJSu.) (.S 3 v ci C©LLb Gb '8-v S'2. S 70 - 2u 7 - o ooa Contractor �J' Address City/State Zip Phone /n1 - Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? ICHere ❑ Report sales tax numbers required by all contractors Are you paying with your trust account? ,✓SLYes ❑ No Is this a residential or commercial project? Be Residential ❑ Commercial If residential, is it: Q(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 <No If yes; you may need to contact Historic Preservation If this is for a demolition permit, what year was the building constructed? Description of work (2-Ivl1'I,/1,- k,yn AZ ,ed +a-f 17 51Lwt+u5 dF AsPaAn ,- Sft, oG� o s - !o a y OLLW 0,2{ 2 S.o2l *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 Other 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: Print Name: �' Jd ��5 Signature Date 24 % Revision dab T/a12011