HomeMy WebLinkAbout5806 Auburn Dr - Applications/Reroof - 10/05/2011From Affordable Roofing Inc 1.970.207.0289 Wed Oct 5 12:15:02 2011 MST Page 1 of 1
a
pitplanning, D�eve>opeautt a TrnansportatlOn
ity t)f
" q 281 N. College Ave P.O. Banc 580
XX
Phone 970416.2740 Far 72446134
OVER-THE-COUNTER PERMITS ONLY
This application is to be used to apply for the following permits only (check all that apply).13 Air CcruMoning
C1 Owndilion (intenior non-struduraQ 0 Racftmal Allonatien (not service change) (7 Gas Lighter 0 Gas tug
�Q Heating Unit 0 Lawn Sprinkler ❑ MoNie Home repo wametA 0 Roofing ❑ Sewer tine 0 Photo-voilaic
❑ Ventilation 0 Water Heater 0 Water Line ❑ WooNPedet Stow (must be EPA canlYei, provide m0n, model and
maanuf eturar)-
Complete all appifcabie information on the applicatlom Incomplete applications will not be accepted.
l4pplit;3tian # �l � 0 � 5 Date iD • 1 I I:l • W
For arEzuasummry
I Job 5ibe Address (reSrwaA) —'--- Value of Construction (labor, mamrfak. mcf t) i
'55'Ak.ice= A na
Property Owner Name Address 6W/Staff Zip phone _
I Appdtant NameAddress l Hy/5tate [4: (Al l.rrj Zip &d515 Phone
_
7 MA
Contractor Address City/Stage Zip phone
jointra= Gty et Ft. Coffins Sal T 3 Are you paying taxes 'We Or by report? ere 0 k °wort
:Sorer bxrnmter&,ap¢medby a$meeaaors Are you paying wllfl your trust amount?l❑NO
Is Utis a resldersGal or commercial prof' tKenvennat❑ Con=Rrdal
If reademal, is it, i3'S4iale Femdy Detached 0 Candoltoss,fmme ( family attaahe0 0 Dupk%
[j Mtdt_tlamity (spannrer=W ❑ Garage
if commercial, is it: 0 Bane E2 Bar 0 C wrdt tJ Itp1Pi/MM6 E! Medical Office 0 OMM 0 Relad
❑ Reurant 0 parer [e4gain)
Is this budding SO years of age or more? Cl Yes Dno Ifyps rrrayne5d ro mn✓8U tfs>Ur c P t=ae wdorr
If this is for a domoltMon permit, What year was die buddng constructed?
it) larro 1975, pw arc// rnx+d an asbzzbw asaaswrtt+nt a� sdxrr7 wdh bFiir cryp t.
p n worts d / .—
f —..
*tf fawn spn&Jer/baddlow (reverter, must list iiceratd phart w, If first time AfG mcut list &armed O-Llln fan.
<Strbmsivadora: Lac Me ;WwnyrraM or Cry ofR Ca*A; km ?
`OcNioar= Aumbrr Other
nedmlaf_ Aoofa
I hereby arkmmlecige that I have read this app jc t and Sale that tha.atme infonWWn is fLmpk3t and comet. I agree t0
comply wfth all regtwemem¢ com ned haeln and city urdl wk= and Ante laws regi feting budding con5"Mmn. I know 00%a
parmk lc not nWW well it has hewn paid and in "- 1 ,
i
printttame:t i iN.t!^� 5 one
�1