HomeMy WebLinkAbout4900 BOARDWALK DR - APPLICATIONS - 12/9/2014 (4)City of Planning, Development & Transportation
281 N. College Ave P.O. Box 580
orl} Collins Fort Collins, CO80524
�. 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 (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement 0 Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ 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 # SIA-I 25! Date i2- 9- /q
For office use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
Property Owner Name Address
City/State Zip Phone
Afld.cd4r %i GC
�{ Z9ys lar0-8 P-�to
Applicant Name Address
City/State Zip Phone
& OOS7zo 97d-Z/9-;?777
Contractor Address
City/State Zip Phone
q70-V "P773
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report? )5-Here ❑ Report
Sales tax number is required by all contractors
Are you paying with your trust account? ❑ Yes §i)'No
Is this a residential or commercial project? Residential )g Commercial
If residential, is it: ❑ Single Family Detached ❑ Condo/townhome (single family attached)
If commercial, is it:
❑ Duplex
0-Multifamily (apartment) ❑ Garage
❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes CMo 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
"If 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 #
Electrician Plumber
Mechanical Roofer
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: // Signatu
Date Z2- 9--/y
7M
C oMt tie u i c P? u�taur: . 8141 LS�I �
1. What is the slope of the roof?
2. Are you going to be tearing off or keeping existing layers? � �i�z� O4
-if keeping existing layers how many layers are there?
-what kind of material are they? ,*/tom e�,Xt/F-57
3. What new roofing materials are you using? X5P1t4r11f ;S/tfAt/t_T
4. Is there existing insulation?
-if there is existing insulation is it staying or will it be removed?(
5. Once these questions have been ask and answered then pass it along to Russ.
1