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HomeMy WebLinkAbout2042 Kent Ct - Applications/Reroof - 06/13/2013Jun 13 13 11:04a Artisan Roof Repairs LLC 970-223-9501 p.1 City of Planning, Development & Transportation 281 N. College Ave P.O. Box 580 �.%ft Coihns Fort Coffins, Co 80524 �— Phone 970-416-2740 Fax 224"6134 OVER-THE-COUNTER PERMITS ONLY This application is to be used to apply for the following permits only (check all that apply). ❑ Air Conditioning © Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas lighter Q Gas Log ❑ Heating Unit ❑ Lawn Sprinkler 0 Mobile Home replacement ❑ Rooting ❑ Sewer Line ❑ Photo-vottaic ❑ Ventil-ation ❑ Water Heater D Water Line (3 Wood/Pellet Stove (must be EPA certified, provide make, model and manufacturer). Complete all applicable information on the application. Incomplete applications will not be accepted. Application # b -36 ag 3 $ Date _ o 3 C 7j (P`14-i3 For office use only 105 -7% Sob Site Address (hw eo Value of Construction (labor, material profit) 67 $ Property Owner Name fil i Y . 4 cpk Address tray/State Zip � -_OL - ,-1 Phone C r6. Applicant lit-«✓ � `75 &VJJC- ress EAdd �YlState Zip Phone /,�,. ifSL �' C�7G Contractor Lic # Address CitYJStatre Zip Phone Conhador City of FL Collins Sales Tax # Saes &Vrnwabarfs mWredby aff wnqac&vs Are you paying taxes here or by report? Are you paying with your trust Here ❑ Report account. ❑ Yes No Is this a residential or oo mercial project? ential ❑ Commercial i If residential, IS It ngte Family Detached ❑ Condo/townhome (single family allzched) ❑ Duplex !3 Kultlfarnity (apartment) ❑ Garage If commercial, is it- 13 Bank. ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office 13 Office ❑ Retail ❑ Restaurant 13 Other (explai ) Is this building 50 years of age or rnone? Q Yes o If yesi Yam �Y / tv rnntacY Histwfc Pn nation If this is for a demolition permit, what year was a building construed? Irprfor to 1975, You w17/ need an aslestns aSgeWaWt to sutrmrt Mbt this appfrotiarc Description of work *If lawn spm*Jer/badittow prem er, must list 6oensed plumber rf first-time A/e, must Gst Gored Subcontractors. List Me =Wnyname orG& offt Co//ins use # Electrician PhunberMechanical Roofer odw I hereby aclvlowledge that I have read this application and stave that the above information is complete and mnatt I agree to comply wfh all reclaim" ents aonlained herein and city ordinances and stake laws regulating building corX;trucwn. I knave that a Permit is not valid until it has been paid and issued 1 AppIk2nt-- Print Name: /kl / KI i ature / / /✓�/� Dale rL� j"�