HomeMy WebLinkAbout919 Marble Dr - Applications/Reroof - 09/16/2011Planning, ID a Transportation
j��.+ a 281 N. College Ave P.O. Sox 580
■ VI l 6111ns Felt Cdit M 80524
Phone 470416-2740 Fax 2246134
ONMR-THE-COUNTER PERM ff S -ONLY
This applIcaliam is to be used to apply for the f UowbV permits only (check all that apply). 0 Aar CwOorft
E3 Derrolf8on (interior non-structuraq E3 SectricalAltraBOn (not service durp) O Gas LOW 0 Gas Log
f] HoWng Unh 0 Lawn Sprirdder o Mobile Home replacernentA%otftg 17 Sewer Line . D Photowofta is
0Ventfladon Q Water Head O Water Line ❑ WooWaeW Stove (must be EPA certified. provide make, model and
manufacturer)_
Cwnplate all applicable kmt ..vmation on the application, Incomplete applications wall not be accepted.
Application Date
Foradke r� .
lob f �►)► Vakw of - (labor ffafthik OMM
��fq 71
APr icant:Nartie Address Oty/gam Tip Phone
.Conftd w Address City/state Zp t3
Conlracw of FL Cflmrs qa Tax 038 Are You payrr>g taxes here or by reporfNere 0 Report
salesaurmarrbarrsragr�dbya�►mnaacm s Are you paying wait your trust acoo inlapOrl O-No
Is this a resfderW.'cr ao prqjecV,,4:rResW&ftl 0 Commercial v
N residentlat, is it: Single Farrn'fy RXached 13 Corrdo/townhome (grigle farW ally led) 0 Duplex
O MutMarnally (apartment) 13 Garage
IF commercial, Is M 13 Bank 17 Bar D Church E3 HoWlHoW 13 Medical oMw E3 optae o Retail
0 Restaurant ,. 0 Other {explain
Is this budatang 99 years of aw a or morel CI Yes • ffpm yeu Owynwd to He rfc ►r
If this is for a demolifion permit, what year was the buikfing amdrucGad7
Ifp*rtv1975, you wi0needenadeswsa rentms IwW with t ap�Lion.
Desdiptit of work r -
Loom
*IP IBM- sprinlder/bactdiorn► pra ventwo must'N licensed pl wtv. If flrs"he AK, must Mt ga' m' and eteKtridan.
Sut>eormoracbors:.L�st1�►ieoyr>tameortSiyoffitar��anee# ,
Plumbs' Medmel0W f Roofer Climes'
I hereby admowfedge that I have read tha ap UcaWri and staIR that the above it mmabon rs complete and aorrat' I agree to
corn* with all requirements contained hereln and dty ardinanaes and stator: laws regulating building construction.
I ka.aw limat a
parent is not valid until It bas been paid and issued.
iiA- frame: l jfl UCGcin - slpnatrrmr+e now
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