HomeMy WebLinkAbout5613 Red Willow Ct - Applications/Reroof - 11/14/2012�( Nov•13. 201Al2:22PM (ADVANCED ROOFING No•5434. P. 1
�\ Ciiy, of � Planning, Development & Trarspormtlon
} Collins
j , i ry;��y�f 281 N. Coileaz ,Ave P,O. 5ox 580
°�or! �L J�(ii�s f I � � (_ Coilins, '
✓ �� .]°�`.' -.Phone 977-4io-274G ax 224-0:3'
OVER-THE-COUNTER PERMITS ONLY
This application is b be used tc apply for the following perm its only (check all that apply). Air OonG,iionIr
0 Demolition (interior non-stroctural) � electrical Aitcratl0n (iiCt service C. �2j:CJ?) Lr' Gas !�'htaf .1 Gas i-OQ
L' Heating Unit L L avm sprinkler 0 Motile 'Home r8placement XP Roofing Sewer Line ! '' %`:i`Oto-Voltalc
Ventilation 0 Wa`er f' eatsr �� Vi Ater Line ie E: WooGPallet Sieve (ML'si bE =�A Car!iiEc, provide -nake; modal and
manufacturer).
Complete all applicable information on the application. Incomplete applications will not be accepted.
Apoiicatlon 9 )a Igo (0 °e73 Dat.,= I `-• ��-«� �'�
For otiCa U-na ONy
I �,.L �Iap • rL�..:J.:jr�� (i,:.c.y_✓: If vet_ - _ !labor VW ,rJu
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Prope:'cy Owner Name Address
City/State Zip
Phone C170
14�
Applicant Name Address
City/State Lip.
Phone q7(D
�' l i ((2S� ('3
1( C- �IY�� y �1J �JL,
/✓k7 �.yj
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Contactor Lc s Address
Ct`1/S _te Zp
phone
Contractor City of Ft. Collins Saies Tax #
Are you paying taxes here or by -per? ❑ Here
❑ Re,:,cr
saiEsi�PxnwrGw-s-4urr=deyill
Are you paying with your v!us ac:C'rL? P�Y?s
❑ Na
a 9t�Sr.�
:s this a residential or c
ommercial proje=0 In Resldenzal ElCommercial —
if re<_ldent7c4?5 it; L'S('SinCgle `amlly.7e-ched"' ❑ C,^,r^,d6/iOWr��CrE (ffiriClE i�YPiIIV 3icCiled) ❑ oul.'leX
❑ Multifamily (aparmi,entge
IT commeKlalr IS 1: Bank ❑ Bar ❑ Church ❑ HctnW iotal F-1 Medl-31 OiiiCe ❑ OfEcE ❑ Re'tgll
❑ Resturant ❑ Cj er (expiain)
is this building So years of age or more? ❑ Yes 6�Nc Ifyes, ycu iray17eed'4o cones cn'iszrr,•'c?; E52r✓aVcn
u this is for a denelition permit, what year was the building cnn=-tructed?
r,oriGr t0 1575, you will neap✓ an a_cbesft�T ae:_SSnert t0 submit w,,' 7? ;cis applii�cion.
o1 work
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1
if icWl- Spry ij(i4.'ICcC!CICW praVeiiicr, fitL'_rt list iICEclS$d plurnrer. If :r..i:_z_
n",e iu[, mL'57L Ilse ilCe!"i58'_4 E;ec:rlGan.
Subcontractors: Ls.'tG;etnr,;xnyrer,;ecrOr/Cff: collirslice T �\
_,_ idz^ v,� yE`anir�t c oie S il_( Cthe•
I herety ac%,,iowledca mat I hav5 rand this zociiC3`icn -nd _Z-a'" ti^ fC, .
.-t�.� a c� n2 abCY2 ini a rnat(Ci rr 1S C.^,�T�DIew and Cor, Ect. 1 acree t•1
Comply w.iGi.al( fcyUlram£fG COntainEd (1Eralrt end C;tJ Ordinances cr:d Seta ia.VS r2cu(= iig tiCil ;n� :OnSu`-G-(o�. i know tn2i 8
permit is net valid until it has been paid and issu�d�
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frry�,,
A iicant' ,,r� G l `1
Print N2m=:� i'1(X ��P . ?�� f Signature �l)�rl( vf/ u r Cate 1 d
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