HomeMy WebLinkAbout314 E Mountain Ave - Applications/Reroof - 08/23/201208/23/2012 00:26 FAX
12001/001
Cft CALUI'iS
Planning, Ddr4W*Pmmnt rkTrainspormeon
282 N. College Ave P.Q. Box 5$6
Fort Collins, GD 80524
Phone 970-416-2740 Fax zz4-r;z3r
OVER-TH&COUNTER PERMITS ONLY
This application is to be used to 4pp1y for the f4flowing permits only (cheek all that apply). E3 Air Conditioning
C2 Demolition (k tsrior non-structural) ❑ Electrical Altemdon (not service change) CI Gas Lighter ❑Chas Log
a Haating Unit 0 Lawn Sprinider C1 Mobile Home replacement X Roofing ❑ Sewer Une ❑ Photo-vottaic
❑ Ventilation Ci Water hteatar ❑ Water Line 13 Wood/Pellet Stove (must be EPA certified, provide make, modal and
manufacturer).
Com01448 an applioabi lntarmation on the appiioallon. Inoomplete aWleations will not be accepted.
A 301citlon # ,' -t-2-05-1 0.3 .� 6
Job Site A�d/drew (reg/1J~ y/ (/ / a Val
ue of C:ons�tction laabor, matariefs, pror*
I, W1 `�/✓f�1f� r All l4f /VtiS $
Is this a reskienVal or ooLttl1merc7al project? 0 Residential G Gommerdal
If reskWMal, is it: —Single Family De tad -ad t7 Condo/OOWhhW& (single family attached) Cl J%plex
O MummmW (epattmeM t„i Ggrage
If commercial, is iD 0 Bank G tar O Church 13 Flotel/Motc! 0 Mediml office II office CI Retail
C 1 Ratdumnt ❑ Cther (0*181n)
is this building i3t) ye am of age or more? O Yea MNo !J'ye{, yore meynraed m mnfacth9 taric Gran
7" is for a dernolttton par nit, what year was the budding constltrcW
�� to 197�y you we'! --coed an amarmn�at in svlxnVt �tYr tluFs ePP�
cf work
*It t3Mm sptlnkfer/barkdtow premnter, must fist licensed piumbrtr, If flrst-time A/C, mta list Ica and
ntr.ctorss lit' lire awipW name ofCf[y ofAt C Av Ands° 0
mmbw Nertenital Roofer _t� I ! t Other
I hereby admwledgs *at I haft read tills appkadon and seta that the abom information is complete and correct- I agree to
ODm01y wth all mWmemu is cont8iatld herein and dty on2r>a m aril sh t laws Iiulating tx Nng conatrvtsion. I krww that a
pe nnh is net valid unto rt has baler paid alai "mlrtlad.
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