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HomeMy WebLinkAbout925 COLUMBIA RD - APPLICATIONS - 10/22/2014From Affordable Roofing Inc 1.970.207.0289 Wed Oct 22 16:16:46 2014 MST Page 2 of 10 City, of Planning, .Development & Transportation 2$1 N. College.Ave P.O,. Box 580 brt Cothn ej Fort Collins, CO 8OS24 ��qq ��gg Phone 99770{-44116®-2274400 Fax 224-6134 OVER"THI&COUNTER PERMITS ONLY This application is to be used to apply for the following permits only (check all that apply), 0 Air Conditioning ❑ Demolition (interior non-structural} 0 Electrical Alteration (not service change) 11 Gas Lighter ❑ Gas Log 0 Heating Unit 0 Lawn Sprinkler 0 Mobile Home replacement ❑ Roofing 0 Sewer Line 0 Photo-volfaic Ventilation p Water Heater d Water line 0 Wood/Pellet Stove (must be EPA certified, provide make,model and manufacturer). Completeall applicableinformation on the application. Incomplete applications will not be accepted Application # 151-1 1133 2- For offce use only Job Site Address (required) Va tie of Construction (labor, materials, O profit) Property own-- Name Address t(Yl i S iC�h I-�i 11 S. L nc� dtl4 i llp" City/State S u � + C Zip �85U 6lGtnd �(' t00 ��[olltn P4�one o (, CIO qS(708 I Anpplicant Name Address CFry/State zip Phone 70 Contractor Address /State Zip. P Phone Contractor City of FL Collins Sales Tax # Sa/2s:rar nwnb-rts required by all Contractors: Are you paying with your trust account? 2'Ye5 ❑ No Is this a residential or commercial project? residential 0 Commercial If residential, is it- r�rsfngle Family detached 0 Cbndo/townhome (single family attached) ❑ Duplex ❑ Multifamily (apartment) 0 Garage If commercial, is it: Cl Bank 0 Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ office ❑ Retail Restaurant © Other (explain) Is this building 50 years of age or afore? ❑ Yes [].No If yes, ynu may need to Contact HistvrlcPrawrua6on If this is for a demolition permit, what year was the building constructad7 Ifpjor to 1975, srou W11 need an asbesias assessment to submit with this app1 tron. V lawn :ion of If first time A/C, must list licensed electrician, Subcontractors-- Ustift companynameorGfyafFi Co11Ir1sllceirse zF must listiicensed 61ee�lclan Plumber. Mechanical Roofer-y.—IIR51 Other I hereby admowledge thatI 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 Itnow that a pernit.Is not valld until it has been paid and issued. Applicant- Print Hums: r' ) r Signature ..... . ...... . . I .... ..... ............-............