HomeMy WebLinkAbout613 MEADOW RUN DR - APPLICATIONS - 8/19/2014.NgC)' 3
Planning, Development & Transportation
City of 281 N. College Ave P.O. Box 580
�Oj t COIIi'"15 Fort Collins, CO80524
Phone 970-416-27402740 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 ® Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line O Wood/Pellei Stove (must be EPA certified, provide make, model and
manufacturer)
Complete all applicable Information on the application. Incomplete applications will not be accepted
Application # � I ca 0�5-713 Date ( 9 ( 1
For office, use only _
]ob Site Address (required)
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CO $d52S
Property Owner Name
Address
City/State
Zip Phone
Applicant Name
Address
City/State
Zip Phone
Contractor
Address
City/State
Zip Phone
CAPITOL ROOFING INC.
6540 S. COLLEGE
FORT COLLINS
80526 970-223-5600
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes
here or by report? )d Here ❑ Report
❑ Yes XNo
Swigs%�xnumderrsrepuiredbyancono-adors.
Are you paying with your
trust account?
C7t i�s
Is this a residential or commercial project? ®-Residential ❑ Commercial
If residential, is it: �J-Single Family Detached [ICondo/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 K No If yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
If prior to 1975, you will need an asbestos assessment to submit with this application.
Description,of work
11
`If lawn sprinkler/backflow eventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or City of R Collins license
Eleanuan Plumber
Mechanical Roofer J,� i�Other _
I hereby acknowledge that I have read this application and state that the above information is complete and correct. r dy[er tu
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: CAPITOL ROOFING INC Signature
Date
41