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HomeMy WebLinkAbout2918 Eastborough Dr - Applications/Reroof - 11/05/2012City 0 P9lannirqjr Development 8t Transportation } �!�+�� 281 N. College Ave P.O. Box 580 Fo,.1 t � otfins Fort Catlins, CQ 80524 Phone 97G-416-2740 FaDc 2246134 OVER-THE-COUNTER PERMS ONLY This application is to be used to apply for the following permits only (check all that apply). 0 Air Conditia 6n9 ❑ Demofifloh (interior non-strruaturaq ❑ Electrical Alteration (not se ce change) ❑ Gas Lighter ❑ Gas Log ❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement Doling ❑ Sewer Line ❑ Photo-vollaic ❑ Ventilation ❑ Water Heater ❑ Water Line la Wood/Pellet Stove (must be EPA certified, provide make, model and manufacturer). Complete all applicable Information on the application. Incomplete applications will not -be accepted - Application #, I Ol�-1 l %V Date 11 -�-) �l2- lob Site Address (nqulnw) Value of Construction (labor, mare:iais, Vv t'ptL � Properly Owner Name Address C lty/State Zip Pho Applicant Name Address city/stage Zip Pimni Contractor Address city/statezi h 777 C — w'� an� CC7 as3 Contractor City of FL Collins Tax # �41©�St Are you paying tars here or by report/ ❑ Here ❑Ir Sb/estaxramrber�nwp�baOby�aMbac4irs Are you paying with your trust account? [] Yes ❑ Is this a residential or commercial project? [�R Idential O Commercial If residential, is it O Single Family Detadnecl ❑ Condo/t ownhome (single family atbKhed) ❑ Duplex Mukifamily, (apartment) ❑ Garage If eonvnercW, is it: ❑ Bank ❑ Bar ❑ Church 0 Hotel/mow ❑ Medal office ❑ Office ❑ Retail ❑ ktestaumnt EJ Other (expla- ) Is this building 59 years of age or mpre2 l7 Yes ` 1 Yves, youmayneied to r HM%*Pres=+rvab'avr If this Is for a demolition permit, what year was the building cm strudied? If prior to i875, you wfll need an asbestos aamwient to subrrbt rA* th/s aWmabon. j Description of work_ *If lawn sprfnkler/baddiow preventiwr, must list licensed plumber. If first-time Alc, must IM licensed electrician. Slubcontrackors: List me Cotnpaany name or [Sty of Cblldxs &0150 # Elecbidarl _ Plumber Medimiral Roofer Clow I hereby adatowtedge that I have read this appl=tlon and stare that the above knfomnation is complete and mrrem I agre Comply with all requirements aonbmied herein and city ordinances and state laws regulating bulkMg construction. I know permit is not valid until It has been paid and issued. i ... `ate i• „ �r ►'i ��ww�. � � �-