HomeMy WebLinkAbout626 ATWOOD CT - APPLICATIONS - 9/13/2011From Affordable Roofing Inc 1.970.207.0289 Tue Sep 13 10:38:25 2011 MST Page 1 of 1
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Planning, Development & Transportation
281 N. College Ave P.Q. Box 580
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
OVER-THE-COUNTER PERAR#'f*0 ONLY
This application is to be used to apply for the following permits only (check all tW apply)- ❑ Air Conditioning
Demolition (interior non-structural) O Electrical Alteration (not service change) 0 Gas Lighter ❑ Gas Log
10 Heating Unit Q Lawn Sprinkler ❑ Mobile Home replacement 17 Roofing ❑ Sewer line 0 Photo -voltaic
i7 Ventilation ❑ Water Heater ❑ Water Line 0 Wood/Pellet Stove (must be EPA certified, provide make, model and
all aoDI[Cable information on the application. incomplete applieationswill not be accepted.
6 // 0 -7 Date
Forofike rU only
Site Address (rWakrO
Owner Name Address
Address
Value of Construction (labor, materials, profit)
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City/State Zip Phone
ctyl5tate Zip Phone
;;Contractor Address City/State !'Fr �b(•+)5 �S�SPho C�
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Contractor City of Ft. Collins Sa Tax # Are you paying taxes here or by report? 7Elere ❑Report
sa/esbxnumberrsrz9�+iredbya!/mnbadnrs Are you paying with your trust account? IXYes O No
Is this a residential or cgmmerdal project?-KResidential I3 Commercial
Tf residential, is it: ngle Family Detached ❑ Condoltownhome (singlefamily attached) 13 Duplex
0 Multifamily (apartment) ❑ Garage
if commercial, is it Bank O Bar 13 Chu
❑ Hotel/Motel E3 Medical office ❑ Office 13 Retail
0 Restaurant 0 other (explain)
Is this building 5o years of age or more? ❑ Yes �tao Ifyes, you mayneed to mniactHuYoric PrPsenraGon
If this is for a demolition permit, what year was the building constructed?
I,rMor to 1975, you tall/need an asbestos assessment to submit t.»6'r this application.
of work
*If lawn sprinkler/baddlow preventer, must list licensed Plumber. If first_time A/C, must list licensed eiectridan.
a Subcontractors: list ehe comParry'name orOcy ofrr Collins'ycelLw
. Becbidan Plumber
Mechanical RoofPl Other.
L hereby acknowledge ihatI have read this application and state that the above information is complete and correct. I agree io
comply with an 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.
1
Applicant: Date
PrictiName: r:41"��5 Lrll!ltto� Signatures