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HomeMy WebLinkAbout1539 W Mountain Ave - Applications/Reroof - 03/19/201303/13/2013 09:40 9704612547 ATLAS PAGE 01/01 f Pbnt tit& � & Tmrapwbdlort City o281 N. Cdiege Ave P.Q. Box 580 C othn5 Fort Collins, CD 80524 Kwne 970-416-2740 Fax 224-6134 OVER-THE-COUNTER PERMS ONLY This application is to be used to apply for the folbwing permits only (check all that apply). ❑ Air Conclitic ing ❑ DernoffBon (interior non-structural) 13 Electrical Aheration (not � ❑ se change) Gas Lighter ❑ Gas Log 11 Heating Unit C1 lawn Sprinkler ❑ Mobile Home replacement 1 Ang CI Sewer Line ❑ PhOW-Voftaic ❑ VeriMor ❑ Wiger Heater ❑ Wald' Line ❑ wood/Pelet Stove (must be EPA certified, provide make, model and manufacturer). complete Sit appooable infomtatmn on the application. Incomplete amlieattons will not be accepted. AppfitaUon # 13 ©(a 2 "1 ,mate Fr�ali>re eras ardy f.//¢� ' 'V tY �• airs A► ♦ • i ��+ � M Ingr ,, , •a r o • r Is this a residential or i projea? E�Readmtfai ❑ Coaunerdal If residential, is � =& R niify DetapW ❑ Cordo/tawnhome (single family afSa hed) ❑ Duplex C7 t+mWamity (apartment) 0 Garage If mmnracial, is it ❑ Bank ❑ Bar ❑ Church D Kotd/Motel ❑ medksl office ❑ Office ❑ Retad ❑ Restaurant ❑ Other (ecplain) Is this buiidmg So Vesta of ape or more? O Yes CINo Ifyes, you mayneedW d Histo1lt'R 6vrr If this is for a demolttWn permit what year was the bwlcling constructed? IPpHor la i975, }�ori uaN need an asd�Ms ass�neytt ra wbrr+r7 wltlt th[saAai. IMME I •.1-. - - 1 -- - - I hereby admmkdge that I have read this aWkadbn and state that the above hdanrratlon Is oampiete and =-Oy with an mgftmmM amdadred herein and city mmiacwes and state taws regulaft f l&q =sbrtac Fag n. I tmow to a . permit is nut valid mudsit bas been paid and issued7. Print Ntitrre• 6Da � Dae ,g Of , ' 4 ae- - a'