HomeMy WebLinkAbout2131 Thunderstone Ct - Applications/Reroof - 06/28/2012Jun 28 2012 8:18AM HP LASERJET FAX
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Colley Ave P.o g ron"rtatian
Fort Collins. CO 80524
Phone 97"irs-2740 Fax 724-6134
-r"Im-counrrER pwo-F% ONLY `' z`y�
C) 0 MONIOnfion far be usd too apply for the following
O DemOMtlon,(pmterlor port -structural � Permlta an
O Heating unit q -struc lam O Mobile Home Alteratlon (not Ito ly�� ak ah that apply)• D Air Conditioning
❑ V �7tbtt d Water Heater p Drama) reAlncament gs) U Gas Lighter O Gas Log
manuFe�hirer Water Ling Q Wood/Petlet Stove mus nbe ❑tower Line ❑ photovoltaic
ComPleta all} ( EPA ce►tfHed, Provide make, model and
ePpfiaebfe (nlnrmatiorr
WWI the.apolleation.
Application # /br Mum oms- only I'Z.dOCU
Job Site AddrM (^ of
PrOPertY Owner Name
APPlicent Name
Contractor
1 Address
Address
Lic # j U LIE Addrass
Contractor city of Ft. Collins Sales a
Incomplete appifoati nO will not nocepte
Date(
� L (gyp
Value of ConstrueUan (labor, materials, prof4
city/Rate . Zip Phone
Gty/State Zip Phone
CRY/State ZJP Phone
1 1
Are You payinb taxes here or by report? M Here IJ Report
Are You Paying with your tru§t adoounO ❑ Yes dl No
Is this a residential or CO
al projew Residential p Commercial
If residential, Is It: �Sinole Family O'b * d Q poni"Orm O Multifamily (apartment) O Garage (� family attached) ❑ Duplex
If commercial, Is It: O Bank O Bar D Church 0 Hotel/Motel 0 Medical offte p Office ❑ Retan
O Rdsturant 0 Other (explain)
Is this building 80 yeonl of spa or more? G Yes 17 No NW nftdit, =nteeCt/� prey rraVon
If this Is for a denullitlon pelt, what year was the bulldhV constructed?
hip kr to IVY, YW * f!/ ~ an ambesfas Awessrnent to svbmk w*r this appGicaebva
Of
*Ir sawn sprinWer/tom pmeventer, must list tk ensed plumber. If Nrst•time A/C, must list Ikamned el,ectrldan.
Suboon :L&Abe=Mp .V or0?YofFtCalNnre-WSd#
Ele�tmlden_„„�` Pltgrmter
panic k Roofer . other
I hereby acknowledge that I have rend this application and state that time above information Is complete and ox, I agree to
comply witim all requirements contained herein and city that a ordinances and state lane regulating building construction. L iknowpermit Its not valid UM 1t has been paid and fssued.
Apptkyat:
IPrint Name:
n
Slpnature
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