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HomeMy WebLinkAbout1464 Edgewood Ct - Applications/Reroof - 05/09/2013 (2)05/08/2013 14:07 19702 211 ROCKY MTN ROOFERS PAGE 01/02 OVER-' This application is to be used to a 0 Demolition (interior non-structural Ci Heating Unit ❑ Lawn Sprinkler I El Ventilation 0 Water Heater O 1N manufacturer). Complete all apply" le Wormatic Application # 15 130 c'2 1 Far ofto use only lob Site Address (repumed) 6 2 fa5awo00 Manningr oeMopn%mt & Transportation 281 N. College Ave P.O. Brno 580 Fort Collins, CO 80524 Phone 970-416-2740 FdX 224-6134 NTER PERMITS ONLY ply for the following permits only (check all that apply). © Air Conditioning ❑ Electrical Alteration (not service change) M Gas lighter 11 Gas Log Mobile Home replacement i"00fing 0 Sewer line Q Photo -voltaic ter Line El Wood/Peilet Stove (must be EPA certified, provide make. model and on the application. incomplete applications will not be accepted. 14 Date -r ` F` ( 3 S/9 Value of Construction (labor, materials, profit) $ 3010 Property Owner Name �Am E✓ QULCK A3017 Address a City/state Zip Phone 02 ry.tr Codiv TW;4 a(q-fo 7/ Applicant Name I Address City/state ,Zip Phone Contractor i.ic # K i` 910ct -y ' NWLi r% i e 3 Address 5- UN n City/sum Zip 2 Fi`C g05Z Phone Contractor City of FL Collins Sales Tex tarmmzber[sregr®adLiy�O # L4 1'j'"+,(_ p r Are you paying was here or by report? ❑ Here Are you paying with your mist account? 36 Yes Aj Report © No is this a residential or commercial i*Residential © commercial If residential, is it: -CI Single FarMly Detached P-Condo/townhiome (single family attached) ❑ Duplex 0 Muitlfarnily (a rtment) 0 Garage if comrrmciai, is it; E3 Bank 0 Bar E3 Church i3 Hotel/Motel ❑ Medical office ❑ Office 0 Retail ❑ Restaurant ❑ other (explain) is this building 50 years of age or m 3rb? ❑ Yes iWNo ffycs, yvu flay need to contact His ri[ PrNeiva" If this is for a demolition permit, wt at year was the budding constructed? irpfor to 1975, yvu W# need an mttls os assem9nent to submit with ifiis applkaffbA of work *If lawn sprinider/baddlow presenter, subeonWPctors: List rt>e company rc Electrician - I hereby aclaKwiedge that I have read comply with all requirements contained permit Is not valid unlit it has been Appiicoj* pdnt(Name: o°y d D w "✓ " oe t list licensed plumber- V first-time A/C, must tilt licensed eldct or Gary afF Collin Ilrense # 0 h 9*-X e 4 - goo 1�-t -L5 Mechanical_ - - Roofer other gAcaWn and state that the above intbrmation is complete and correct I agree to i and city ordinances and slate laws regulating building construction. I know that a and issued. Signature ii m V - 3 -Fm5T kcc oun+