HomeMy WebLinkAbout5944 Mars Dr - Applications/Reroof - 07/29/2013From Affordable Roofing Inc 1.970.207.0289 Mon Jul 29 09:24:21 2013 MST Page 2 of 2
C itjc p{ Plannilrq, Development & Transportation
aa 281 N. College Ave P.O. Box SAf,
�,..•�� �a.`s> :.w Fort Calliru, CO 80524
�^ Pimrte97 AIC1 2740 Fax Z24fit34
OVER-THE-COUNTER PERMITS ONLY
This application is to bo used to apply for the tollowing permttronly (checkallthat apply). ❑ Air Gandiburdng
G Uentoliiion !interior non=slructvrap Q Electrical Atzeratior. (not service change) Q Gas Lighter ❑.Gas Lop
C Heating unit D Lawn Sprinkler n Mobile Home replacement Xfiooling CI Sewer Line ❑ Photo-vaitaic
Ventilation ❑ Water Heater C'. Water Lune ❑ Woodweltot Stave (must be EPA renifled, provide make, model and
manufacturer). ,
Complete all appii ble Informations on the application. Incomplete applications will not be accepted.
09
Application #-1,. Date
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oflPce ruse mA•
Job Site Address (MquLgxr�
--------- ._...
Value Of Construction Ia ,'. nratvnals, pro1R
r
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Prhperty Oyer Name Address
City/Sta[r_ Z'tp
Phone $o ff
tNOvA� r.v:-o; ? t
Ycettlw5 /o holr-�
zv i
Applicant Name Address
City/State Ztp
phone r-i -A5 - 1
T.:tKc. ail W.tzk (Te, C4
Contractor Address
_ety/state Zip
Fgtorre
Cctractor City City of R. Coilins Sales Tax W
------ -----....
Are you paylr1g taxes isle or by report? G Here
❑ Repeat
'Qrmfar.Wm, -r K rwwrW by a9 mvra,-r
Are'you rhlyiny wive yarr tmst account? ❑ Yes
0 No
; iS Culls a re5lrk'.R1t31 Or COn111x7c1'al projcrct? aC'i Rr�iderrtiat EI.Ccnnneroal
If rcsidentrat, r5 it: 0 SintjEe Family la:facnrd Q Catde/towrrhouk (tingle family atl-adted) Q GWplcx
Q MultitainilY (apartment Q Garage
If evnmrercial, is it: ❑ Bank Q Bar ❑ Church Q.H(meUMcmei q MediCal office ❑ Office O Retad
0 Restaurant Q Other (explain) -_.._....._-_-_._—_..__.
Is this buildirg.50 years of age or rhuM? Q Yes d No If ye5,. Wu rrzry need to r-M."ac1 Hh7oiiC />a,s-, ✓afirur
1 rt this is for a demolition permit; what year was the building canstructec? _—_— -
ff prw to 797_ti, yvu wrlr ntieV arr asbearrs aeyessrrif»t m s(lbnv? miji HAN Y")P/ira!gvL
Description of work '(',ear a--c ti rf-.ALce e.xi. 4-Iv+a r-e,c—C wi'I-Yt s"r
•lf Wvm spnrdclar/badr(fow, preventer, must flst Ik:cr!sLW pkardter. 1f first -Use A/C, -must ks: 6trensed electrician.
Subeontraetan: list tAr rmn,-x<q. rctrue a C?y w At C,*ns kcr,ts:= qe
FJrstricsi_____________________ Pkxnixr_--..............._ hWhankal,,,,,__,,,,,,,,,....._, R00W _R-- 1KSr)____ Other_-__
I hereby ack,iuwtedile that I have read this application and sta+: that the atime Information is mtnplete and conea I agree to
comply wlth all requirements contained herein and city onl:naves aril state taws re9dating bulktinn consmktien I know that a
permit is not valid until It has been paid and issued. - - -
Applicant: r�,..........
Print Nacre: - /4 », ., e w w, i xq.S Signature '`'.: .,• ... .7 C7" -/•S
._._.. .V1 el...� ....---�----�-Date ....