HomeMy WebLinkAbout1138 Aruba Dr - Applications/Reroof - 07/26/2019City of Planning, Development, & Transportation Services
Fort Collins Community Development & Neighborhood Services
281 North College Avenue
Fort Collins, CO 80524 Main: 970.416.2740 Fax: 970.224.6134
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) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ 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 # J, Date
For office use only
7/26/19
Job Site Address (required) Value of Construction (labor, materials, profit)
1138 Aruba Drive $10620
Property Owner Name Address City/State Zip Phone
Karen Horning 1138 Aruba Drive Fort Collins / CO 80525 (970) 581-9114
Applicant Name Address City/State Zip Phone
Jeramiah Larsen 8543 S County Rd 13 Fort Collins, CO 80525 (970) 690-1020
Contractor Address City/State Zip Phone
Anchor Roofing 8543 S County Rd 13 Fort Collins, CO 80526 970.666.0321
Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? 9 Here ❑ Report
Sales tax number is required byall contractom Are you paying with your trust account? 9 Yes ❑ No
R-2446
Is this a residential or commercial project? ❑ 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
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes 91 No Ifyes, you mayneed to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
Description of work Reroof; Install 44.25 sq of Malarkey Legacy CLASS 4 Shingles;1 story; 8/12 pitch
*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 R-2446 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:Jeramiah Larsen Signature Date 7/26/2019
Revision date 2/6/2017