HomeMy WebLinkAbout942 BUTTE PASS DR - APPLICATIONS - 8/6/2014Aug 0614 01:57p Severe Weather Roofing
970-223-3383 p.5
Fort Collins
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Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fort couirls, 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). 0 Air Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo-voftaic
D Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable information antheapplication. Incomplete applications will not be accepted.
Application # r�l� I OS� Date 816/2014 I 1 C� -�►5
For offlee use only
Job Site Address (AMU ed)
Value of Consbwbon (labor, materials, profit)
942 Butte Pass Drive
$2000.00
Property Owner Name Address
Crty/State Zip
Phone
Stacey Palm 942 Butte Pass Drive Fort Collins CO 80526
970-218-9550
Applicant Name Address
City/State Zip
Phone
John Anderson PO Box 2207
Fort Collins CO 80522 970-2-23-2455
Contra=r Address
City/State Zip
Phone
Severe Weather Roofing PO Box 2207
Fort Collins CO 80522
970-223-2455
Contractor City of R. Collins Sales Tax #
Are you paying taxes here or by report?
ItHere ❑ Report
Sales tax number &req~bya#m7racrors
Are you paying with your trust account?
❑ Yes ❑ No
50255
Is this a residential or enoal project? IfResidential 0 Commercial
If residential, is it: 57ingle 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 Cexplain)
Is this building 50 years of age or more? ❑ Yes ❑ No Ifyes, you may need to ch n&xtHistaric Preservation
If this Is for a demolition permit, what year was ttfe building censtrtleted?
YpHor to 1975, you will nod an asbestos agent to submit with this application.
Description of work Remove 20 asphalt shingles to decking and replace with 20 asphalt shingles to
code_
*If lawn sprinlder/baddlow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: Gist the company name or Gty offt Cofts license A
Electrician Plumber Mechanical Roofer
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. 1 know that a
permit is not valid until It has been paid and issued.
Applicant: 8I6114
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Printniame:_ John Anderson signature JZ_L ' pate