HomeMy WebLinkAbout3235 MOORE LN - APPLICATIONS - 9/11/2017Sep 11 17 12:15p Severe Weather Roofing
9702233383 p.2
F6etCity of Planning, Development, & Transportation Services
Col[Ins 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) 0 Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing Cl 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 # �r� �/ 5 5 s C7 Date 5 1,
y
Job Site Address (required) Value of Construction (labor, materials, profit)
N1C'1L>.. (A 2
Property Owner Name Address City/State Zip Phone
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Applicant Name Address City/State Zip Phone
Carly Fronsee 3307 South College Ave. #220 Fort Collins, CO 80525 970-223-2455
Contractor Address City/State Zip Phone
Severe Weather Roofin2 3307 So. College Ave. #220 Fort Collins, CO 80525 970-223-2455
Contractor City of R. Collins Sales Tax # Are you paying taxes here or by report? ❑ Here ❑ Report
sales tax number is required by allcon&=ury Are you paying with your trust account? Ci Yes ❑ No
R-2152 Please Call For Payment
esidential ❑ Commercial
Is this a residential or commercial project?fhed
If residential, is it: �ngle Family Det❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apart ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑explain)
Is this building 50 years of age or more? ❑ Yes If yes, you may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
Description of work
S C
*If lawn sprinkler/backfiow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors. L/st 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: Carly Fronsee
Print Name: Signature a `E
-UUU_ Date
.Reyvu date 276R017
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