HomeMy WebLinkAbout613 ARMSTRONG AVE - APPLICATIONS - 4/15/2019City of Planning, Development, '& Transportation Services
VPFort 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 ID 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. 1
Application # I� " 2 Date
For office use only
Job Site Address (required) Value of Construction (labor, materials, profit)
613 Armstrong Ave., Fort Collins, CO 80521 $8000.00
Property Owner Name Address City/State Zip Phone
Christopher & Hein Holmquist -Johnson 613 Armstrong Ave., Fort Collins, CO 80521
Applicant Name Address City/State Zip Phone
CHRISTA ROBISON- PEBLEY PO Box 270705 Fort Collins, CO 80527 970-460-8720
Contractor Address City/State Zip Phone
AMERICAN ROOFING AND RESTORATION PO Box 270705 Ft. Collins, CO 80527 970-460-8720
Contractor City of Ft. Collins Sales Tax # Are you paying taxes here or by report? ❑ Here ❑ Report
Sales tax number is required by all contractors: Are you paying with your trust account? ❑ Yes 10 No
00136633
Is this a residential or commercial project? 1Z Residential ❑ Commercial
If residential, is it: O Single Family Detached ❑ 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 ❑ No If yes, you mayneed to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
Description of work Re -roof; Windspeed 130mp; Lifetime warranty; Class 4 shingles; re -deck
r
.
*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 00136633 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: Christa Robison-Pebley Signature Date 4/12/2019
11,
Revision date 2/6/2017