HomeMy WebLinkAbout2301 Plains Pl - Applications/Reroof - 07/24/2019clty of Planning, Development & Transportation Services
�t CO�llns 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 servi 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 #AM X,1'-) 2 Date JUL 2.4 2019
Wr owe rtse only n-lr ')1 U1f i 5 (0 2cP
Job Site Address (requied) Value of Construction (labor, materials, profit)
1/6 zS 8055 t-770-91
Property Owner Name Address City/State Zip Phone
C r e s �7o6 `
Applicant Name Address City/State Zip Phone
f /L
Contractor pia' dress city/State Zip Phone3-�
Contractor City of Ft. C ' s Sales Tax # Are you paying taxes ere or by report? ❑ Here ❑ Report
Sales tax nwzberrsregtOWbya(/cowacYors Are you paying with your trust account? ❑ Yes ❑ No
Is this a residential or commercial project? esidential ❑ Commercial
If residential, is it.
ingle Fatuity Deta hed ❑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,WNo Ifyes, you may need to contact HsIn icPrewivadon
If this is for a demolition permit, what year was the building constructed?
Descnpti n of ork �
es
�3 `
*If lawn sprinkler/bacidiow preventer, must fist licensed 6lumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the cvmµany name or City of Col%hw kbrme .#
Bectndan PlurttxY Mechanical J Roofer Other
I hereby acknowledge that I have read this application and state that the above information is complete and correct I agree bo
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.
6 PPiint Name:/BE 1 Nelf Signatu Date z.
Ro j,i a date 26W 7
50,