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HomeMy WebLinkAbout624 MORSMAN DR - APPLICATIONS - 8/18/2015Aug.18.2015 11:49 AM Slaughter Roofing Co 9703305645 PAGE. 2/ 2 Fort Collins OVER-TH This application Is to be used to apply ❑ Demolition (interior non-structural) ❑ E ❑ Heating Unit ❑ Lawn Sprinkler ❑ Mo ❑ Ventilation ❑ Water Heater ❑ Water I manufacturer), Complete all applicable Information on Application #,_._.L5.0617` For office use only Planning, Development & Transportation 281 N. College Ave P.O. Box 580 Fort Collins, CO 80524 Phone 970-416-2740 Fax 224-6134 PERMITS ONLY the following permits only (check all that apply). ❑ Air Conditioning Ideal Alteration (not service change) M Gas Lighter ❑ Gas Log Home replacement 11 Roofing ❑ Sewer Line ❑ Photo -voltaic I ❑ Wood/Pallet Stove (must be EPA certified, provide make, model and application. Incomplete applications will not be accepted, Date 8/18/2016 Job Site Address (required) Value of Construction (labor, materials, profit) 624 Morsman Dr $2,200.00 Property Owner Name Address City/State Zip Phone Sue Jorgenson 624 Morsman Dr FortCollins/CO 80526 970-223-6146 Applicant Name Ai dress City/State ZIP Phone Michael Slaughter 9 6 38th Ave Ct. #6 Greeley, CO 80634 (970)330-7881 Contractor A dress - City/State Zip Phone Slaughter Roofing CO 9 6 38th Ave Ct, #6 Greeley, CO 80634 (970)330-7881 Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? a Here ❑ Report sales fax number Is requlmd by all contractors. Are you paying with your trust account? MYes ❑ No 38653 Fort Collins License #R-1703 Is this a residential or commercial project? M Residential © Commercial If residential, Is it; E Single Family Deta ed ❑ Condo/town home (single family attached) ❑ Duplex ❑Multifamily (apartm nt) ❑Garage If commercial, Is it: ❑Bank ❑ Bar ❑ C lurch ❑Hotel/Motel ❑Medical office ❑Office []Retail []Restaurant ❑O her (explain) Is this building 90 years of ape or morel Yes ❑✓ No 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 a essment to subm/t w/th this app/icallon. Description of work TEAR OFF SHING ADEQUATE VENTILATION & DIMENSIONAL THE BASE FELT PAPER, DRIP *If lawn sprinkler/backflow preventer, must 114 licensed plumber. If first-time A/C, must list licensed electrician. Subcontractors: List the company name or Cf'ty of Ft Collins license 0 Electrician Plumber I Mechanical Roofer OLMEDA #R2279 Other _ . I hereby acknowledge that I have read this ap ilcatlon and state that the above information is complete and correct. I agree to comply with all requirements contained herein iind city ordinances and state laws regulating building construction. i know that a permit Is not valid until It has been paid d Issued. Applicant: : M� Print Name: w Signature - ,s2 Yy Date