HomeMy WebLinkAbout624 TYLER ST - APPLICATIONS - 8/14/2018Aug 0218 01:29p Severe Weather Roofing 9702233383 p.1
FCity. of Planning, Development, & Transportation Services
ort Cottins Community Development & Neighborhood Services
281 North College Avenue
Fort Collins, CO 80524 Main: 970.416.2740 Fax: 970.224.6134
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' 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 # e1000�P3SS Date
For office use only
Sob Site Address (required) Value of Construction (labor, materials, profit)
Property Owner Name Address City/State Zip Phone
1 D-1U � C'Lc buclG d Sam I L,N 96 -'-"
Applicant Name Address City/State Zip Phone
Szt7zn� ' YOO+n6 �, Cfii ae }�Ue #CLJ i i t, Ct�ii� n5 Co OC�5.ZS q-V-- 123 —2A SS
Contractor IJ Address City/State Zip Phone
�ver� tl7a°a li�tQr" Q n� 330 �5: CoIIQ 2 ZW F+.t;c uos (0 P�ZS 9lu-223• 74S5
Contractor City of Ft. Collins Sales Tax rk Are you paying taxes here or by report? Mere ❑ Report
salestax numaarlsrequiredbyallcontractnrs Are you paying wittl your trust account? ❑ Yes S<No
Is this a residential or commercial project? gResidential ❑ Commercial
If residential, is it: %Single Family Detached ❑ Condoltownhome (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 buflding 50 years of age or more? ❑ Yes XlNo If yes, you may need to contact H&odc Preservation
If this is for a demolition permit, what year was the building constructed?
Description of work 64i ►lP S -F A S SW 4 {-4`1 I s
*If lawn sprinkler/baclfflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name or0tyofFtCollins license#
Elect6clan Plumber Mechanical Roofer Cher
I hereby acknowledge that I have read this applicaton 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: Ar
Print Name CV ` (�� �' (� `(cy.,^ ' ` signature_ Date
Revlsl0n Cate v612017