HomeMy WebLinkAbout2000 Constitution Ave - Applications/Reroof - 08/25/2011Planning, Development & Transportation
City of 2Si N. College Ave P.O.3cx 580
Port Collins For; Collins, CO SocZ4
phone S70-416-27a0 Fax 22=5-:=
OVER-THE-COUNTER PERMITS ONLY
This application is to be used to apply for the following permits only (check all that apply). r Air Conditioning
Cl �emoiiiicn (interior non-strS.,e:rai) C, Eiectiical ,'ltamUon (rct service chance) C Gas Lighter G C2S LGC
❑ Heating Unit ❑ awn 5prtinkier L MCbile:Home raClac-sment ❑ F{cOnng J Sewer Line C P'noto-voltcic
❑ Ventilation C Water r=eater C Water Lane C` Wccd/r'2ila� Sieve i'must be wr;ified, provide make4 mncdal a,,d
manufacturer). _
Complete all applicable information on the apelicaticr.. Incompleta a.plicaticns will not Ibe accspted,
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ProFe^/ Owner Nar,e
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n Ix "YIIlls C'D 80
phone / /0
l(^70
Acolicsnt Nam Address
City/St= Zt- Zip .
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Contractor LC # Address
Zip
Phone
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Contractor GL`1 of F:. Collins Stiles i ax ,r
A.— you paling tzxzs `are or by re; cr?
Hera Ci Reccr`
tiles is.ruirr'ays/r
Are yeu paying with your r—fF, 2cCourt7 Yes C No
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Is this a residential or commerc2l proja~? �iiEsdert 2i ❑ Conrercai
If res�drznt°21', i5 it: Nngle=am:ily D? oCle_' ❑ Ccnda/townhcr ($inClc ftC'ily a� = hECf) ❑ Duplex
❑ Mulufaniiy (aoartmenG) ❑ Garage
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if CGmmerc'2l, is it: ❑ Bank ❑ Bar ❑ ChurCn ❑ �C� 11�'iCi21 ❑ I�AEd1C=! CriC2 r QfiICP ❑ ke:al
.❑ nesnurant ! 1 Other (ex lair.)
Is tidiis building So years of age or fore? . ❑ Yes *No ifyes, ypu r„„ayneed to ccrp;c: H,7F(oncA_scer2tcn
If thlS iS `or a dernoli`jon permit, W;1a* year W25 the building CGnst ❑C zd?
Ifprer to 1975 y %/ will nee ,64 asbe�-cs as-eSSme^t io s✓bnit Mitt ibis zppllc-c'r,.
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.f fawn, sprinklerfGa ',C'CW arc /e.,te., d p1uT:=er. ii ill 5 Une y C, rl'S iIS ilC'n5c� d1 "iCiB( .
x- r r r rills ,I<C IlgenSs
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Eiecrican Fluster.
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I h.arc�y 2CC GH/IcrC$ alai I have iced is 2QCIICa Gn and S ci2 t et C;lE =CCVe IRfGf 12 Qf• i5 =rnpiata cGd CGrrc `- I cGf22 u
CGmply with 211 ccuircmE�tS =r�`inEd ill cif: c".d C;t`/ Oi:ara•^.Cat -.^.d '_tc 12''•ti'S rc;!'lerne builClnc Ccns"ec_ier,. I knew fiat a
permit is Clot valiC until it has been paid and issued.
Applicant:
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