HomeMy WebLinkAbout5208 Parkway Cir E - Applications/Reroof - 07/24/2019CkofCol
PlarsM19;1eveiopfnent, & Tmnsportation Services
�' � 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 permute only (check all that apply). O Air Conditioning
❑ Demolition {interior non-structural) Q Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
O Heating Unit O Lawn Sprinkler 0 Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater Ci Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer)_
Complete all applicable information on the application.
Application # J u l m u S (OU S
Foroffica use only
Incomplete applications will not be accepted.
Date l - ay-)q
3®b Siite Address (required Villue of Construction (labor, materials, profit)
Jr�0,S ( ,ti• o� 7 )31 O
Property owner Name (� Address City/State Zip Phone
� �CCR '►JEN><5N 15 ],rf,e, gi5gS
Applicant Name Address City/state Zip Phone
Majestic Roofing LJ G 6200 N_ Garfield Ave Loveland Co 80538 970-667-8500
Contractor Address City/State Zip Phone
Majestic Roofing L l-G 6200 N_ Garfield Ave Loveland Co 80538 970-667-8600
contractor Clty of it Collins Sales Tax # Are you paying taxes here or by report? 5 Here ❑ Report
sales lax number isrequlmd by all mobaclois Are you paying with your trust account? 21 Yes 13 No
Is this a residential or commercial project? ® Residential ❑ Commercial
if residential, is it: ® Single Family Detached ❑ Condo/bownhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church CI Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant Q Other (explain)
Is this building 50 gears of age or more? ❑ Yes W No IfyE5, you mayneed to contact Hi5ioric Presenob`on
if this is for a demolition permit, what year was the building constructed?
Description of work Remove and Replace Shingles 4a'�' ) W%,,4;e (\ S40 Cl c'
1 ila Col Nails 6 per Shingle
*If lawn sprinkrer/baddlow preventer, must list licensed plumber_ If first-time A/C, must list licensed electrician.
SUbCoeb' rs: List the company name or G[y of Ft Collins license #
Electjdan Plumber Mechanical Roofer R-1510 Other
I hereby acknowledge that I have read this application and stag that the above information is complete and correct. I agree to
comply with all requirements contained herein and city ordinances and state lams regulating building construction. I know that a
permit is not valid until it bassi beenpaidand issued.
Applicant: 6/tI SignatureNU Y •
Plains_ *W g
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