HomeMy WebLinkAbout4501 SEAWAY CIR - APPLICATIONS - 3/27/2015From Stone Creek Roofing Exteriors 1.303.500.5469 Tue Mar 24 11:39:10 2015 MDT Page 2 of 2
City{o�f For Planning, Development & Transportation
Collins N. College Ave P.O. Box 580
F®I l Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134 Gi8
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) O Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation O Water Healer O Water Line ❑ Wood/Pellet 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`J®� Cl�� Date
For office use only
Sob Site Address ftqulmd)
Value of Construction (labor, materials, profit)
4501 Seaway Cir
$$r1�7'f3 00-M
Property Owner Name Address
City/State Zip Phone
Svea Worley 4501 Seaway Cir,
Ft. Collins 80525 970.222.2896
Applicant Name Address
City/State Zip Phone
Tika Porter 1567 Skyway Dr Unit A
Longmont, CO 80504 303.772.5700
Contractor Address
City/State Zip Phone
Stone Creek Roofing & Ext. 1567 Skyway Dr, Unit
A, Longmont, CO, 80504 303,772.5700
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report? ❑ Here ❑ Report
5aiesMxnumnerismquiredtyall mdtartors.
Are you paying with your trust account? ❑ Yes RI No
Is this a residential or commercial project? Q Residential ❑ Commercial
If residential, Is it: ® Single 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 (explain)
Is this building 50 years of age or more? ❑ Yes Q No If yes, you may need to contact HlstoricPreservation
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 Replace roof on entire dwelling per contract scope and building code; tear down to decking;
one story: 20.66 SQ
*If lawn sprinlder/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: Ust the company name or City of Ft Collins Acense 4
Electriclan Plumber
Mechanical Roofer R-0914 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. I know that a
permit is not valid until it has been paid and issued.
Applicant:
Print Name: Signature Date
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