HomeMy WebLinkAbout7209 Ranger Dr - Applications/Reroof - 09/12/2011pity of Planning, Development & Transporta I tion
281 coil
Ave P,Q. Box seo
Fort Coltins Foit. �oojlinsj 00 80$24
Phone 970-41&Z740 Fax 224-6134
OVER-THEMCOUNTER PERMITS ONLY
This application is to be used to apply for the following permits only (check all that apply).O%A4 Con ftionvV
01 Demolition 6 1menor ral) 0 eactrical Aliprabon (rvaj� service chant w as .norv-sLructu 66r, Lighter 0 Log
%Hearing UNt 0. Lawn Sprinkler 03 fvtotb?Ie Home repliatcement 0-Booring t3 Sewer,Vw 0 PlIcto-voltak
D-Vantilition 0 Water Heat6t '0 Water Cutts 0 Wc)rxl1P8;01'=I Stove (must be EPA certfW., provirle make, model and
complete all appliemble infory.n4lion, on the application. Incomplete applic4tions will not be accepted.
Application Date q112-
Adr
Job Site Address Value of Constructiots (tabor, matmals, prom)
O.& r
Property Oviner Name Addres,5
oty/state, Zip
phone
C 'i�11�1 4 70)2ZH
'12-e7
Appficant N"kme
ob/Istate -ZIP
Phone
c2q0ys
Iski— 7ky!
CoMactor Uc Address
city/state. zip
Phwe .1
Contr&-,tor City of FT. Collins Sales T' ax
AreIM Paying tastes : here or by reparo &Here
On pepart
Are jou paying wrrh yGur trust account? b— Yes
X�No
Is.this a resiclentlal car commercial proms? ieq? Identlai atorrinvercial
'It refidentlaki, is It,: -2-`rWgle Familly Detadte d, Iml Conti PdOly attathed) 0 Du*.x
0 Muftifiammy.(apartme"t). 0 Garage
if Commercial, Is A- 0 Sank 0 Bar C] Chatch 0 Hoteil,*tel 0 medical of 0 Office. D Retail
C1 Resnqra�t 0 Other (explain)
Is.rhis bullding $Oyears.of age v more? QyA,5
if this is for a demollition permit what ye.3rWa5 the builcFIN onsnaed?
If prior tO 1497�1 YM
-f-
-*It.fMvn sprink I leffbackhow p`reh.Tnter, r,-.j5t 1151 �irensxad -pumber. If :$rst-firm4jC, must list libbnstd Cwt0dwi.
Subcontradors, Liq tf�e ,ke 0�y ceq C4 I
Sectridan. Plarber Wier
1 htrtby acknowledge that I have read this apphcation and stark miht the above infor-matic)n is 4mmplete and cared. I agree tD
comply with all requirenentS core mein and city ordinances and state laws regulating bvif*ng wnsvuctlon, I know that -a
permit is n6tvalld Until It has beer paid and Issued.
Appficant
Ptim Name, Ua�tj iLL, 22,1t4-�e iC.( sionature
Date —1L—