HomeMy WebLinkAbout6562 FINCH CT - APPLICATIONS - 9/12/2011From Affordable Roofing Inc 1.970.207.0289 Wed Sep 14 10:35:20 2011 MST Page 2 of 2
Planning, Development &'transportation
City of =
A r, 281 N. College Ave P.O. Box 58i) �i c
( a Fort Collins, CO 80524
= Phone 970-n6-274o Fax 224-6134
OVER-THE-CtiUNTER PERMITISONLY
This application is to be used to apply for the following permits only (check all that apply). 0 Air Conditioning
I7 Demolition (interior non-structural) 0 Electrical Aiieraiion (not service change) 0 Gas Lighter 0 Gas Log
P Heating Unit 0 Lawn Sprinkler ❑ Mobile Home replacement 0 Roofing ❑ Sewer Line ❑ Photo -voltaic
,i7 Ventilation ❑ Water Healer 0 Water Line Cl Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer),
omplete all applicable Information on the application. incomplete applications will not be accepted.
Application Date
For ofike use only
;Job Site Address (requilao
value of Construction (labor, materials] profit)
j ,!Pfaperty Owrlet Name
Address
City/State Zip Phone
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lApplicant Name
T
Address
—
City/State Zip Phone
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Contractor
Address
Ctiy/State 7;f-, 1U4,.4S Zp Phone
i able
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(.t1, Tr I CD &525 e207, LIDDI
Contractor City of Ft Collins S
Tax #
Are you paying taxes here or by report? 2�Here 0 Report
Sales taxnumberlsraquuedbyaUmnozmars
Are you paying with your trust account? 5ki'es E3 No
!� is this a residential or o9mmercial project? XResic entiai O Commercial
` If residential, is it: 3ingie Family Detached ,Cando/townhome (single ;amily attached) i7 Duplex
.13 Mulafannly (apartment) 0 Gauge
'If commercial, is it: ❑ Bank. G Bar ❑ Church 0 Hotel/Motet 13 Medical office ❑ Office 0 Retail
0 Restaurant 0 Other (explain)
s this building 50 years of age or more? O Yes -y6o lfye, you mayneed to contact HistoricPresevvatfon
1 iIf this is for a demolition permit, what year was the building constructed?
�. ifprior to 1975, you will head an asbestos assessment to submit wid7 this appikatfon.
of work
lawn sprinkler/back low preventer, must list licensed plumber. if first-time A/C, must list licensed electrician.
Subcontractors.LrstthecomeanynamacratyofFrcof§nsfcenwe
Electrician Plumber Mechanical Roofer: Otter
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 slate laws regulating building construction. I knowthata
permit Is not valid until it has been paid and issued.
fApplicant. r ,n
'Print Name: C+e^�tl +^ 1,1! In.� `� signatures Date