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HomeMy WebLinkAbout5820 Plateau Ct - Applications/Reroof - 09/01/201108/29/2011 20:01 FAX la001/003 i Of Pla203. niCg,,age vea opniia P.Ot Tftne�"vo ns Fort Coin, co m24 Phan 970 416-2740 Pax 224.6134 This appRoad ❑ De mo6tion Irrtertor ( D Heating Unit ❑ ❑ Ventilation ❑Water Manufacturer). re n � . Na R-THE-COUNTER PERMITS ONLY its aPp'y for the following permits only (cheek all that apply). 13 Air Conditioning ral) E3 OeaMca! Alteration (not service change) ❑ Gas Lighter D Gas Log rinkler C Mobile Home replacement J<Rooflng O Sewn Line D Photo-va to r D Water Line ❑ Wood/Pellst Stove (must be EPA certified, provide make, model and Complete all appll Appucatton # i l nnetion on the application. Incomplete kmhtione will not be accepted. C00 late 1 1 L.ZP Sob Site Addt+ees CS 0 P I Cl` value Of COn9ftcdoe Qabor, matarfals, profit) u Ct coo©, 00 Propefty Owner Namel Address � � y//�te Zip �� - 9 Applftarrt Name I Address Qy/stafe :F�• Lo 1.1 In zip W52-4 phone a3..2� Contracoor Au, R1`1 Address ❑ty/stat8 V- -000yd ap �062,j Phone l o n 3. Z Contracoor City Of Ft 44111ru 'rra+rruntbitr Sales Tax ;t Are you paying taxes here or by report? Mere D Report mrneaas Are you paying wfth your trust account? D Yes WNa Is this a r+esskismal or If reddn al, Is T: If eomrriarefal, is it. D 13 Is this butkltng tap yinal If this is for a deed D`prrah► W 19;% yew ng ul a project? R,estdenmi D Commercial Family Detadsad 13 Condo/twArnhome (single family attached) 0 Duplex (apertment) O Garage D ear D Church 0 HoteyMoW O Medkol office 17 Office D Retail urant 0 Ottwr (axel�l�) or more? D Yea No )fyrri, you may j m amehr firzowisc oresm"A rr t, what year was* ldrrlg axw& c%e an esG i a to submit fwzb dr& Awasttvt Description of work V ' Q - k00 V 0 *If lawn sprinidar/ w p , must.®st licensed plumber, If first-time NC, must ash II electrloan. name ort�ofR Axw0 F7i! Madre kd Rehr L— E Other 1 hereby adorwvl comply With all rehalned penrhit 4 not m Ij rtmd this appikedon and stabs tat the above information is eomp� and correct I agree tp herein and dw ord orwas and state laws reguistlng buoding consi ucslon. I know that ■ been paid aihd (awed. tjrint lyalhls• SlOnmbnre pate