HomeMy WebLinkAbout425 W SWALLOW RD - APPLICATIONS - 8/8/2018wortCity of Planning, Development, & Transportation Services
Collins 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 # M QJO .Q S13
For office use only Date
Job Site Address (required)
Value of Construction (labor, materials, profit)
I � � � -5 �✓ Q/�G� cci
Property Owner Name 09. 3 �
Address City/State Zip Phone
Applicant Name - - - -, , . `. • �' d 5?. (; ` 7u- �/� - � z 7
Address City/State Zip Phone
Majestic Roofing LLC 6200 N. Garfield Ave Loveland Co
Contractor 80538 970-667-8500
Address City/State Zip Phone
Ma estic Roofing LLC 6200 N. Garfield Ave Loveland Co
Contractor City of Ft. Collins Sales Tax # 80538 970 667-8500
Ar
raxnumaerisrequiredbyallconr27ors. e you paying taxes here or by report? a Here ❑ Report
saiesAre you paying with your trust account? M Yes ❑ No
Is this a residential or commercial project? ® Residential ❑ Commercial
If residential, is it: ® Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office Cl Office ❑ Retail
Is this building 50 year Restaurant of age or more Other )
❑ Yes Q NoIf Yes, You may
need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
Description of work Remove and Replace
1 114 Coil Nails 6 per Shi
*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 #
ElectricianPlumber
Mechanical Roofer R-1510 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:
5% R ✓Tj
Signature
Date /rs
Revision date 2182011