HomeMy WebLinkAbout636 ROCKY MOUNTAIN WAY - APPLICATIONS - 8/2/2013From: Alex Kight Fax:
To: +19702246134 Fax: +19702246134 Page 2 of 2 8/2/2013 8:17
City of Planning, Development & Transportation
281 N, College Ave P.O. Box 580
F6i 1} � Collins Fort Collins, CO 80524
Phone 970-416-2740 Fax 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 B 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.
Application # 1✓1M 4M
For office use only
Incomplete applications will not be accepted.
iat 8/22013
Sob Site Address (required)
Value of Construction (labor, materials, profit)
636 Rocky Mountain Way
Fort Collins 80526
Property Owner Name Address
City/State Zip Phone
Jedn Higdon
Applicant Name Address
City/State Zip Phone
Alex Kight
Contractor Address.
City/State Zip Phone
Denali Roofing LLC 6944 Rosemont Ct, Fort Collins, CO 80525 970-660-4417
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report? ❑ Here B Report
Sales tax number isrequired byall contractars.
Are you paying with your trust account? ❑ Yes 8 No
49209
Is this a residential or commercial project? B Residential ❑ Commercial
If residential, is it: B 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 9 No Ifyes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
Ifpr/or to 1975, you wi// need an asbestos assessment to submit with this application.
Description of work Remove existing roof and Replace with a new shingle roof
*If lawn sprinkler/backfiow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or City of Collins license #
Electrician Plumber.
Mechanical Roofer R2111+, 3040-R 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: Alex Nght Signature _ Date 8/22013