HomeMy WebLinkAbout4021 Berwick Ln - Applications/Reroof - 06/28/2013From Affordable Roofing Inc 1.970.207.0289 Fri Jun 28 10:35:28 2013 MST Page 2 of 2
Pia nning, Development & Transportation.
281 N. Colla_w Ave P.O. FHJx 58D
Furl Wins, CD80574
.r~•�- _ Phonc 9'/0-416.2740 fax 224-6134
OVER-THE-COUNTER PERMITS ONLY
Tbts opplication.le to be used to apply for the following pah-nit.s.orrby (check:all that apply), 0 Air C:cnditoning
Ci Demolition(iriterior ncn-ste_mtural 0 Electrical Alteration (not service change) D Gas Lighter 0 Gas t.og
(3 beating Unft a tisivn 5ptir kler Q Mabila Nome r t3c rben4 Rooti g Cl. Sewer t.ina [7 Photo•voifafc
❑ \rertW.ati<Jrr' 0 vsreter Hawer 0 VS"ater line 0 WoodiPsile, Stove (must be EPA; cortitiad, proGids moue, macl.J and
rttdntJfa(aUrarj, '
Comploto all apolicabla Information on the application. .Incomplete application ill not be accepted.
APPlication A.At.,� . `a
o1........_.. Oate
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Jcb Site Address (P,-4v tvrl) Vsiue of CbsIrtrUctlart (labw, rnatcrKns: prurit)
t't t:•f..t { ('- �I. Li �/. A.J �r�i�fr+R.%+�' - -'
FNprrty Owner -Name_ Addrt s cit!'/St-te il;s. Phone
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Applicant Name Aakrress
City,,5tafe
23p
Phone
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cCs SCaS,B:j
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Ccntra�r Atid.m,:5
CityrState
zip
Pllosp
Ca; itraw r City of Et. Collins Sales Tax &' Are you paying taxes here or by report? ID Hem O Report
.sr,L�rar,� ,&,a"VW rd4Wal'e>:macaa AM You W,Yingwith y(Al-rrustacmun;? C;yes ❑Mo
..........
Is this is residential or ccmmemial project-? iW Residential ❑ comme.c;al
if residential, is it: {& :an'glc Fttiniiq' Re�ctied C7 C.tiiTdo/tc>vvnhome (jingle "arhiiy 2lfad!P.d) ❑,Dupicw,
i
0 Multifarnaly (apartmertt) i:l carage
if ctwilmbrbal, * it: U Bank ❑ t1ar 0 Murch Q ttct_evMutet 0 Medical 0mce 0-Mice 0 Ri tail
17 Restaurant C] other (eQJiai,r, ) _----------------------------- ---- _ _........-
is vlis uuilulrltt So Years of age ur nwre? 0 Yea tl No leye4, )471jnrwv ruxl to m:ri^J[f.His;Sm"C.'Fyrsarw lion
E It thts.ls tnra demalitit n permtry wh?t Year -vas Ghe; h llding constnlcdv7?...._....................____—______
I L°°y-•ilar it 19;3,:Ya% w%/l i2'vyJa r :rstx::ttr:� am^.sner.-: n arfMrit wlU thr, ayr�tcalirJ,rr.
'
Qesai tion of Work .Inc n-.r--f-_� rF Y7 a�•r�S,�Yt= _'__ _ ... ,'p,-(�
I (1.[tt.:1 <.l L•4: [r _.�i�tk:'.lz7c2i`t.?--'.f.�i raiJ_+;-s=�J1.t'^..a.: `� � �.(�---
If lawn sprinkler/hackrinw prevenber must list licensed ptumtpv. !t first •nine AJ , must pst Irttataad elecGStl3n.
Subcontractws:t.orr/re ctxr;VcxrY9pmie,x r.7ry•a,!ri CnllMs xxtn•;.c. ,a
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%Miter_ ................_..... t0X1Ytu1P.1_.............—._ R:Ofsr i\� (a Q iitlpr:.
tftf i hzrr?tty attirgavitntge that; have read dus zppiicztton aM vale rivet the atmve inrwrtwtlun is cexnpbete and`epne�. I egier.to
E Cam* ak;n ait.rewrententr contalwd tterelr% and rJly crdina=S and Stab_, Laws regtxating buB9nn mnstruraon. Y know that s
!11 permit is rmt t alid until It has been.Raud and issued.
Print Name;_ w- J evtri tvtG S SigrtatrJte_ _ '>_ `'. ••_ _..._....—.—bate........;...;4'
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