HomeMy WebLinkAbout613 ROCKY MOUNTAIN WAY - APPLICATIONS - 5/7/2018City Of Planning, Development & Transportation
C 281 N. College Ave P.O. Box 580
! �6rtCollins�Fort Collins,.CO
Phone 970-41616-2740740 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 ❑ 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 #
`Pj 1 w0t)3 (00 Date % I 105
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For office use only
Sob Site Address (required)
Value of Construction (labor, materials, profit)
613 Rock Mountain Way
$6585.15
Property Owner Name
Address
City/State Zip
Phone
Doug Schlueter
613 Rock Mountain
Way Ft. Collins, CO 80524
970-222-9523
Applicant Name
Address
City/State Zip
Phone
Betzy Sanchez
614 5th Ave
Greeley, CO 80631
970-395-0406
Contractor
Address
City/State Zip
Phone
Bob Behrends Roofing, LLC
614 5th Ave
Greeley, CO 80631
970-395-0406
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
IXHere ❑ Report
saiestax number isrequiredbyall contractom
Are you paying with your trust account?
D(Yes ❑ No
41034
Is this a residential or commercial project? iR Residential ❑ Commercial
If residential, is it: ❑ Single Family Detached R Condo/townhome (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 building 50 years of age or more? ❑ Yes XNo 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 work Tear off 1 layer and install 301b felt. Install ice&water shield in valleys & eaves. Install edge metal at
rakes & eaves. Install Duration Storm Estate Gray shingles. 19sg. 1&2 story
*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 R-1772 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: Betzy Sanchez Signature
Date 5/1/2018