HomeMy WebLinkAbout2019 Brookwood Dr - Applications/Reroof - 10/10/2011Phnnin& Development & Transporlatlon
�rl f''�� 281 N. College Ave P.O. Boot SW
R VI i tioHins Fort Collins, CD 80"A
ate 970.416-2740 Fax 22+6134
OVER-THE=COUNTER PERMITS ONLY
This application Is to be used to apply for the following permits only (check all that apply). O Air Conditioning
O Demolition (amterior non -sin Ural) O Electrical Alteration (not change) 0 Gas Lighter O Gas Log
O Heating Unit O Lawn Sprinkler O Mobile Home replacement �oolUrg 0 Sewer Una .O Photo voltaic
O Ver dletion O Water Heater 0 Water Line ❑ WoodlPellet Stove (must be EPA cartified, provide make, model and
manufacturer).
Complete all applicable information on the applicatlon. Incomplete applications will not be accepted.
Application #8 f 16] Date
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Is this a r eddential or commercial project? JWpasidential O Conmerdal
If maidential, is it. --&SNgle Family Detached 17 Cbndo/tmvnhome (single family attached) 0 Duplex
0 Multi m* (apartment) 0 Garage
If commercial, is It: 13 Sank 0 ear 0 Church 0 Hotd/MoW 0 Medical otnce O Office O Retail
❑ Restaurant , 0 Other(explaf )
Is this budding SO years of age or more? O Yes jErNo. rfy you maynead m c>anfad fr7s�ric Pra rr�arr
If this is for a demoNOon permit, what year was -the building consbuded?
11`prkrto 1975, ytV wil/need an adlesfns ameswj& t to suhrAt'4 di ibis appJkatlon.
Desaiption of work
*If lawn spdnkWbaddlow preventer, must Mit tieensed plumber. F fl setime AfC,' must tat 1censed electrician.
Subeonbactona: List the mmpeany name or ofaCo fit Arw 0
6eW'iden fi Medoni at Roofer
Other
I hereby admowladpe that I have mead this application and state that the above information is compleebe and correct I agree to
con* with all requirements contained herein and city ordkEmms and state laws regulating buttd'atg consvucdom I Imow diet a
permit is not valid until it has been paid and issued•
I�iob �-jocl nSignature Ib� 10-tip-�i
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