HomeMy WebLinkAbout204 Mae St - Applications/Reroof - 03/18/2014Mar•18. 2014 4:10PM ADVANCED ROOFING No•7092 P. 1
Planning, Development & Transportation
City, Of j y 281 N. College Ave P.C.I. 9cx 580
�t Collins For Collins, CO 80524
�• Phone 970-416-2740 Fr, 224-634
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 (1Wterior non-structural) ❑ Electrical Alteration (not service change) 0 Gas Lighter _� Gas Log
Heating Unit 0 Lawn Sprinkler 0 mobile. Home replacement Rooting ❑ Sewer Line ❑ Photo -voltaic
ElVentilation 0 Water :'sater ❑ Water Line ❑ Wood/Pellet Stove (must be SPA certified, provide mike., model and
manufacturer).
Complete ail applicable information on t�heapplication, Incomplete applications will not be accepted.
Application n � pate ..�� ' ;:; - • �
For oft.- use only
Job Site Address (rear;'m�) Value of Crust-oc!ion (labor, rra. er; ,profit)
Property Owner Name
Andrea
Gty/Ste Zip
Phcnp
Applicart Name
Address
city/State ZIP.
Phone Cj -ib
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Contractor l is »
Address
C-rty/stet! ZIP
Phone
-1
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Contractor Cbtr/ of Ft Collins Sales Tax
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Are you paying taxes he, or by report? Here
0 Pepor t
It
21WWrnumher(srqurYedbya//=&2C;nr,,
Are you paying with your trust ac=unt? Yes
p No
�40SCo _
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Is this a residential or commerdal project? Xlk; dental ❑ Conmerdal
If residential; Is ft. , ..A. Single Family Deta&ed, ❑ Cdridd/towhl off0e (silh�le farnfly 6 - d) ❑ Duplex'
❑ Multifamily. (apartmient) D Garage
If Cnmmerdal, is it: ❑ Bank 0 Bar El Church ❑ Hotal/Motel ❑ Medial office ❑- CiFice 0 petail
C.r Restaurant Q Ott er (explain)
is this building 50 years of age or more? ❑ Yes No If yes, you may nee.7to cent2G rls<ar,'c P, esFrvation
If this is for a demolltion permit, what year was the building constructed?
If prbr to 1975, you will need an asbestos assassmi nt to submit wrt5 this appllcat/on.
71
*if fawn sprWkrer/bec0cw prieventer, must F t licensed plumber, If first-time A/C, must list license- e!e:`ricar.
Subcontractors: Lk U;e com�oary rem, e cr Oil oPFt Collins rc=nse f
Mechanical Rc.ofer U C omen _
Mec`idan Plumber
Iheraby ackiowledye that 1 have read this application and state that the above informal on is cornpfete and correct. I agree to
comply with•all requirements contained herein and city ordinances end •ate laws regulating building -cnstruction, I know that a
permit is not valid until it has been paid and issu -'
Applicant: 1
Print Name '� r Sign ure Date .S — ��-