HomeMy WebLinkAbout919 SHORE PINE CT - APPLICATIONS - 8/18/201408/13/2014 1:13AM FAX 9704938868
City of
ort Collins
OVER-TH
ACC ROOFING INC
1M0001/0001
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
LATER 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) ❑ E I trical Alteration (not s ry change) ❑ Gas Lighter ❑ Gas Log S� ❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement Roofing ❑ Sewer Line ❑ Photo-voksic 020
❑ Ventilation ❑ Water Heater ❑ Water Lire ❑ Wood/Pellet Sto must be EPA certified, provide makes, mndal And
Complete ail o plipbid Information on th'e application. Incomplete applications will not be accepted.
IV 14 N ®� �N b m - I
A n V ��� .A !I/ Date
For ofte use only
Job Site Address (requlrlad)
Value of Construction (labor, materials, profs)
919 Share Pine Ct,
4700.00
Property Owner Name Address
City/state Zip
Phone
David Nelson 919 Shore
Pine
Ct. Fort Collins/CO. 80525
970-232-6923
Applicant Name Adress
Clty/State Zip
Phone
Jonah Lovendahl 1713 E. LincolnIl
. #13-3 Fort C911ins,970-493-2801
Contractor Ad
ress
Cc7ty/state Zip
Phone
ACC Roofing, Inc. 1713 E. Lincoln
I
Ave. #B-3 Fort!QolliM CO. 80524
970-493-2801
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
Here Report
saias bxrwrnber&mquiredbyair conaacra .
Are you paying with your trust account?
es No
42178
Is this a residential mmercial project? {Residential ❑ Commercial
If residential, is it: Single Family Detach ❑ Condo/townhome (single family attached) ❑ Duplex
Itifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Ch 1 rch ❑ Hotel/Motel ❑ Medical office ❑ Office 0 Retail
❑ Restaurant d er (e lla�)
Is this building 50 years of age or more? Yes l� No If yes, you may need to conted Histwlc Preservation
If this Is fbr a demolition permit, what year cis th ilding constructed?
rfprior to 1975, you will need an asbestvs assessment to submitWM th/sapp/hatlon.
Description of work
*If lawn sprinkler/backflow preventer, must list
plumber. If first-time A/C, must list licensed electrician.
Subcontractors: W the company name or G of Ft Call/ns 1kense #
Electrldan Plumber Mechanical Roofer R1819 Other
I
I hereby acknowledge that I have read this appil6tion and stage that the above Information is complete and correct, I agree to
comply with all requirements contained herein a Id city ordinances and state laws regulating building construction. I know that a
permit Is not valid until it has been paid an� Issued.
Applicant:
Print Name: Sonja t ignatYre I B QiLt Dabs 8/12/14