HomeMy WebLinkAbout5613 Red Willow Ct - Applications/Reroof - 11/13/2012Nov•13. 2012 10:36AM ADVANCED ROOFING
City of
Port ColtinS
No•5424 P. 1
Planning, Development & Transporrarion
281 N. Coileg2 Ave P.O. Box 580
Fort Coilins, CO 80524
Phone 970-416-2740 =ax 224-0184
OVER-THE-COUNTER PERMITS ONLY
This application is to be used to apply for the following permits only (check all that apply), air Conditioning
Dernolition (inferior non- _ c4Tur„!) V E-Ject ICal Aite, atio'n (i ict Service &,�angge) —7 Gas Lighter -:1 Gas iAg
❑ Heating Unit J Lpawn SCrink!cr D Mobile Home raDiacamerl "I" Rooring J Sewer Line ' ! PhCto-Voltalc
Ventilation i� water =i&atar _l water L ]ne U wood/, 911et S'LCVe (MQSt le A, C2dtITieg, urgVlde—,.Eka� model End
ri IanU;acturer).
Complete all applicable information cn the application. (ncomp(ets applications will not be accepted.
APPlication # UI %—U� l$� Date
For of ce use only
Property Owner Name
Ad&2 s Ci"�/StEte Zip
Phone
mW 6'(�l��l k'�� Sid 13 P�� lei �ll3lLS G-� C'alll
Apc!iC-nt Nar^,e
Address Ci y/S atc ZIP,
Phore C70
;'�P,r���,-t�iC� 1Fr",,i-:r-�'(�;fes
�'�� t5?E�� U� 1�nr,� �.• !�(lrr�����' �'J.� ��'���>�
�C�._�5��3
Contractor L c
"%(f6 2ES Gty/State 7
Phone
�V ~� 1
I LI iT ��
Contractor City & Ft. Collins Sais Tax
# Ara ycu paying taxes here or by report? 0 Here
E. P,eperr
Sa/Es3x,7unbs-s, ✓rr=dtydllcurt=cr_.
Are ycu paying witrl your Ll-'st acgcur ? tkyes
C No
90 SRO
IS u115 d r2=idencal or C.7mme."Cal Nroje;:? IPesidental ❑ Commerdal
I
I` reld_n�^I 5 ii;SinyiE ; Family DE zcnee" L dC(tcwn`or'.e (slnc!e ramify at` e`ed) CI Duplex
❑ Multi-rnUY (apartment) 0 Garage .
If cnrmm�erdal, Is it: ❑ Bank 11 BC2r ❑ Churci ❑ Hc'L2I/Motel ❑ Me�fiC?i 0f.IIC-- ❑,CffiC` ❑ Ke:yli
C FZeS'umnt Q 0*�.e1r (-xpiain)
is this building 50 years of age cr more? 0 Yes P,,,Nc If yes, yGL' r 2y r@8d fG ccnt-:: J�isc0(C
If this is for a demolition permit, what y_ar was the building Constructed?
I,`prbr to 1975, you will need =n eseet s (?5s;5ssmert to $XJLIM)t wry tnis 3,13 ticn.
i
*If lawn ShftFl (J1er/GECcicw pri-V2n'Er, rn L- ll_<t tic Er'SeO f.NMbEr'. ii iirSL^ ,i,E A/C, must I!s iira?seQ e! Tt74 *cn.
Subcontractors: L3: 6'e of,Gny cf/F Callin. 1jcense Y @G�`
MEc`zniC,l Zccr=r 1 '( I Gt';e
i nereey zccncvf!2dc2 Mcr I h2;e read this zaciicaticn Brad s[at2 "zt t=,= Ebcy In cr nation is co,;,cly E d Cora I a;re= t•z,
C4r:^.Ply Ylitl,dll rEqulreil`-ray CCri ll?EL` ilEf�irt �n Cii/ c,-f.r 7c=s -andS=L° iavls i2^_CieUriG .F'illllgli �C 'CnSu iJCtlGnI know t�iat a
permit is net •slid'until it has beers paid and s-s R J
i
r �l
A licant: (
Print Name:I 1 1 ,��r� _ Y��P l� Signature �, l j'� l.i 1 �G� f Y o=_ta�� l