HomeMy WebLinkAbout606 RAMAH DR - APPLICATIONS - 10/11/20112011-10-11 10:51 Pinnacle Roofing
8772389205 >> 970 224 6134 P 1/1
Fort Collins
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
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). I7 Air Conditioning
O Demolition (interior non-structuraD 17 Electrical Alteration (not service change) ❑ Gas Lighter 0 Gas Log
0 Heating Unit D Lawn Sprinkler ❑ Mobile Home replacement fp Roofing ❑ Sewer Una 0 Photo -voltaic
0 Ventilation 17 Water Heater D Water Una O WoodlPellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable informaWri on the application. Incomplete applications will not be accepted. (p
Application # b10b9 Dabe /Ob/ //Q
For or 1m use only
lob Site address pwwrred)
40C� I�rn In br,—
value of Construction�pbor, materials, profit)
Property Owner Name Address
/ v M AoeadP3 6t)4
oty/Stall-a- Zip Phone
iltivl
rr• yos-gS- ?70- al -%a
Applicant Name r Address
dd 0 it-hS I c_u- Ca q3Co S,
aty/State Zip Phone
Quc; n e c &nnt co, 0 It l �36.3-59/- 739
Contractor Address
City/State Zip Phone
Contractor City of Ft Collins Sales Tax #
Are you paying taxes tie or by report? ere Q,Kepoit
sabs �'d
aw�rawmadoy8l mn&ad=
Are you paying with your trust; co acunt? Yes
Is this a residential or commercial project? ❑ Residential ❑ Commercial
If residential, is it: O Single Family Detached ❑ Camb/townhome (single family attached) O Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is rc ❑ Bank O Bar ❑ Church ❑ Hotd/Mobel O Medical office 0 Office 17 Retail
O Restaurant O Other (eglaln)
Is this building So years of age or more? I7 Yes 17 No if y es, you may need to cvntaw Mslorfc PAWervatran
If this Is for a demolition permit, what year was the building constructed?
lfprfor to 1975, yvtr W11I W an asbeiftis assie�t m sum mM Lhls appharb n. _ y
blz�rlal .1•
*If lawn sprinlder/bacfdiow pmvenber, must list licensed plumber. 9 flr5t-One A/C, must nst licensed electrician.
SubODnbacbors: List the company name or cny ofR Comas #owse o
l3ectridan Plumber Mechankal- Roofer
Other
I hereby adi nowledge that I have read this application and state that the atwve information is complete and cornea. I agree to
comply with all requirements ow,tained herein and city o dinances and state laws regulating bu9ding construction. I knew that a
permit is not valid until It has bean Maid and isauia:L
Applicant: !
ant Nam: Ta d d IJ e.f1S I cr signature tact I o Il l �