HomeMy WebLinkAbout631 MEADOW RUN DR - APPLICATIONS - 9/2/2014mb
Fort of
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). ❑ Air Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (rot service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement KI Roofing ❑ Sewer Line ❑ Photo voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer). '�) Complete a'Dppl le/tn,form Lion on p licat7on. Incomplete applications will not be accepted
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Applicatioh-# U
For office use only
Site Addressi(requiredd)
Value of Construction (lab r, materials, profit)
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`P]l Om '!Y�YY
C�tlirs
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Property Owner Name
Address
City/State Zip
Phone
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Applicant Name
Address
City/State Zip
Phone
Contractor
Address
City/State Zip
Phone
CAPITOL ROOFING ING 6540 S. COLLEGE
FORT COLLINS 80526
970.223-5600 1
Contractor City of Ft. Collins Sales Tax tt
Are you paying taxes here or by report?
V Here ❑ Report
5alestax numberisrecuiredbyall contractors.
Are you paying with your trust account?
❑ Yes .YNO
0005 Q 0
Is this a residential or commercial project? &f Residential ❑ Commercial
If residential, is it: ® Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
i
If commercial, is it: El Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑Retail j
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes 'fil No /f yes, you may need to contact Historic Preservation i
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.
-It lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or- City of Ft Collins license # -A' p r o n�erl
Electncian Plumber,
Mechanical Roofer Other
I
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 i
permit is not valid until It has been paid and issued.
Applicant: Date
Print Name: CAPITOL ROOFING INC Signature __ -- I
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