HomeMy WebLinkAbout2114 Sweetwater Creek Dr - Applications/Reroof - 10/05/2011From Affordable Roofing Inc 1.970.207.0289 Wed Oct 5 09:45:44 2011 MST Page 1 of 1
Planning, Development a Transportation
City 0f a m 281 N. College Ave P-0. SM 580
Fort Collins, CO 80524
�. phone97()416-274o fat2246134
OVER-THE-COUNTER PERMS ONLY
This application is to be used to apply for tho following psrmils onty (check all that aPP1Y1. 0 Ak Gondi67ning
b Dem g6on (interior nonstructuml) ❑ Eiectriral Afte�lon ,'not service Change) L7 Oae Ugh*F U C-as Lop
p Heating Unit O Lawn SprinkYx 0 Mobile Hone MPLOCement 0 Roofing 0 Sewer Une 0 Phoml"""O ake del and
mo
D Vemi4'Aion CI 11Uater Heater 0 Water Lime Elb Wod Pellet Slone {must be EPA certified Prime
manufacturer)-
cwlilete an applicableinformationon the aPP�+�. lndornpleda app(I�nswfll trot be accep4ad•� �
o eg of I _ Date _� " I _!"
Application # i
ror ol%tcv use rmly
Job Site Address (n q ii'n'dl �,,� /r /` Value of Co,1nstrudlon (labcr, matcrh" prow)
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v�Na�proP�Ytme Address
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:Applicant NameAddress
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SLAJ . T(i N Phone
Address
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CENJSlate Zip
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-AYAre Mu paYln4 as here or by rE.f7orr:T C3 ReDvrt
Conbacbw CltY ofSala-TAXs Are you paYm9 wdh your trust account? es 0 No
SiD\)i GaraVo/�" dIe'iU.'2S 6yar mrMeAeS
ls this a residential or tnmmctoal PMea�
l If rsikmual is it in91e Fam ly r>t Condolmfw wnme (sir�le fam'f.Y ! L71Aep"x
Lj ultilamilY (apart-nent) 0 Garage a Retell
;IT eomrverdah, is it' 0 Bank ❑ 1;3r Cl Church ❑ HiAWN010 ❑ Medical alit¢ C7 (]trim
L7 itpstaurenL R other (e* can) ,r -d Av mnracr Pi tom moon
L5 this Willing $o Years of age ar mbMT 0was fife building ll mO5Yvvied? ��-
. >If This is for a dernolii3nef permik. Y®T m :v4arlr ieaYh :hts anow iba
s rFnrin ro zvrs, you wo nwd err �rsros a - — -
wait
-•..----•----.'... wnba: Y<firA-tlme NC. mesY &zt ttcerte0 eiettricSan.
,.*IT lawn sprinlder/beddlow PrevOlter, must list 4censed DI
yyeb�rrpcacLars: fii'tlrem+Yrrame ur CdY a�RCddvm lfeens'eg other
RWnDCT
Ned:Na�1 ROcf[r
and state ffiat the abtwe Wbff argon is Complete and caned. I agree be
.. i tzV eby adattwledge that I have. read this oPWt®bon and s� taw, v gulsbug building co�ctori- Y know chat a
epinply wilts as rcpuiremerrts oPnrdines) trrYeln and r1N- prdrfTdnt:es .
permit is not valid until it has been paid and iscoed. i C
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