HomeMy WebLinkAbout3212 Norwood Ct - Applications/Reroof - 09/18/20122012-09-18 08:12 Premier Roofing 970.669.9013 >> 970-224-6134 P 1/1
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281 N. College Ave PA. Box SSO
Fort Collins, CO St$24
Phone 974.416r2740 Fax 224.6134
i?rla.ppiioatlon la O to be ER THE-COr the UN1TER PERMITS ONLY
O nemolltion Interior non-structuraq ❑ Elactrioa{ Alteration (not service (check all that agpty). C Air Conditioning
Heating Unit G Lawn Sprinkler O Mobile Home repiaoement 0 Roofing
0 O Gas Lighter O Gas Log
C2 Ventilation O Water Heater 0 Water Line p Wood/peliet Sto$war Un ve (must be EPA certprovide ma
manufacturer). model and
complete all applicable information on the Sopliandon. Incomplete applieatforta will not be sooepied.
oZ Application # I scJ� Date ��
far olrke i m O/W
30b SU Address (nawbad)
.
Owner Name
Applicant Name
Address
uc//P P Address
ContraiMor Oty of FL Collins Saks Tax A
SSW Imrfwm w4rrmuftwbi-oeav&wc&v&
ve"m Of comtm ten (labor, materials, profit)
City/State Zip Phone
.,.)3) Rio �
�
te Zip Phone
4
city/state Zip Phone
Are YOU WIN taxes here or by report? IF Here 0 Report
Are you Paying with your trust account? O Yes 0 No
Is this a residentleI or oommercW Project? 2 Rttsldendal O Commercial
it masldenual, is it: ® -"'VW Family Detached D Condo/Lpwnhome (single family attached) O Duplex
O Muff family (apartment) O Garage
Ir commercial, Is It 0 bank D bar G Church E3 Hotel, Motel a Medkal office C] of s D Retail
CZ It"Uurant O other (mpisin)
Is this OuRding 50 ymww of a1Oe or more? O Yes D No . Vy#4 y�,,1ey y o, testate H/ �
It this is for a dentelier
den pmit, what year was the tnillding const>tiC /m
Ifpnor tD 1",, )w 09 nad sit dOORVs aftewr&nt zo A& 7R WW Ur4sOpIONCArkvl.
"If lawn sprlrlkler/becidlow oreventer, meet list licensed plumber. Ir first-time NC, meat ILA missed 411ectriclan.
Subambactotm list die to Wny name Of 04'offt COOM ita 4w f
EVeMaM plumber MsdurUdlL Roofer other
I hereby wW&*iedga that 1 h" rated this epgicatlon and state OW the above IMbmietlon Is complete end correct. I Wft to
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comPlY with III rcqulrements contained herein and city ordinances and state laws regulating buflding corl>itruenan. L know that a
parent Is not valld until It has been paid and Issued.
A1+rint M11m1e_�iJ .
Date