HomeMy WebLinkAbout4719 MCGRAW CIR - APPLICATIONS - 3/26/2015Mar 271511:32a
Artisan Roof Repairs LLC
970-223-9501 PA
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). ❑Aiditioning
r Con
❑ Demolition in en r non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑Gas Log
❑ Heating Unit ❑ rawn Sprinkler ❑ Mobile Home replacement ❑ Roofing CI Sevier Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ WoodiPellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application #2-OOL4
Date
For office use only
I
Job Site Address ({equired)
Value
• of Construction (labor, materials, prof}
I c f !' � cam:
. ���
/
Property Owner Nai a `
S
Address (i E City/State zip
Phone Z 2C
Applicant Name tt�(ti i'�flC Address City/State
C� Zip
Phone 770
Contractor Address
_— City/State Zip
Phone
Contractor City of Ft. Collins Sales Tax # !
,
Are Salestsxyou paying taxes here or by report?�'Here ❑ Report
numberisrepu�b�1Cantractprs Are you paying with your trust account?
❑ Yes
ND'No Z
Is.this a residential or commercial projecCt .Residential El Commercial
if residential, is it:
Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
n0
fapiBarp
ent) 0
If commercial, is it: Bank p Church ❑ Hotell//AAotel ❑ Medical office ❑
Office ❑ Retail
❑Restaurant ❑ Other (explain)
Is this building 50 yews of age or more? ❑ Yes E3 No If
yes may
you need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed /f prior to 7975, you svO need an asbestos
assessment ro submit w1rh this app/lCation.
Description work
` .
I 1p
'If lawn spriliJder/baMow Preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or City of Ft Collins>lcense #
Electrician_�_ plumber
lvechanicaly-_ Roofer
Other
I hereby acknowledge that I have read this application and state that the above information is complete and correct. 1 agree to
comply with all requirements contained herein and city ordinances and state laws regulating building construction. I know that a
Permit is not valid until rt has been paid and issued.
Applicant:
Print Warne:
Date^