HomeMy WebLinkAbout3212 Sweeney St - Applications/Reroof - 09/29/2011IW8/2011 21:14 FAX
Z 001/001
PlanninW Devefopinott & T rwnsrM MUM
282 N. College Ave P.O. Box 380
ns Fort Collins, CO NS24
1 Mora 970.416r2740 I= 224-6134
4ngtruchtnW)
ER -THE -COUNTER PERMITS ONLY
This application Isused to apply for the following permits only (oheok all that apply). O Air Conditioning
Q Demolition (Interi❑ Electrical Akw add (not service change) 13 Gas Lighter O Gas L.og
IJ Heating Unit Q prinlder O Mobile Home, replacement 3(Rwflng O Sewer Line C1 Photo-voltele
O Ventilation ❑ Water ❑ Water une ❑ WoodMellet Stow (must be EPA eertlfled, provide make, model and
manufacturer).
Complete all appy 1 th
Information on the applis an. Incomplete applloetions will not be accepted.
,�iicald # () 8Oq y-1 Date U 3 O
lob Sft Addreft Value or Carlst m cdon pabor, materials, Prom)
Prop" Owner Name
Address cats dip Phone
Applicant Norm
Corr sftr
ALL.
Address City/Sta s + • (.D 11 i rl S Zip ftf5
Phone
LIC # Address Gty/stag •CDIW6 Zip Fe, .
n. cA n v q . AG
Zq Phone
Z
Contracaor city or Ft
Sblrr terirn+6e►b
fins Saks Tax # Are you paying Laxaa here or by report?
stl cantYarhss Are you paying with your trust axount?
ere U Report
Yes �LNo
Is this a �ea rjp=Zfk
Pro? RefiftrMai G Commerdal
If rssidentlal,ngle C•andly E3 cwdo/ttswnhome (Single family attached)
Duplex
uffl%mlly (epertlnent) 13 Gorage
XFcommerdank O Bar 12Church 13 Hatal/Motel 17 Madkol office 17 omce ❑ Reran
urent O ottwr (eXlldoinq
Ice this bui-Idhof spa or morel ❑ Yea pryM im meY need tv cornadHAWPIfr OraservOW"
1f this is for apermfR, what year was constructed?
D'pntx ro 19an ante a z awn w* to v,*ff l! wl7/r h6b aPOOPtbn
Dex3 iptlon+ i Q - OV -)�' P, 1
1
*if lawn SpMnidr/ prevsn w, must Est licensed PI Miser. if first-time A/C, must list licensed alaCtrlden.
CO prASL6t ppirlpDnynrimeortllyalRG�imllnrrue#
Plumber.Mai+aedo�l RAofk-- OthCr
1 hereby admawladgs dW I have reed this w9 kation and sum that the above Irttbmwdw Is complete and oared. I agree to
comply twAh all requirmw Ms
corolned herein aced day ordlnW= and state laws regulating, building construction. I blow that a
pwmft is not vaiM UW it has been bold aild Issued.
plifit
• siga„d„e, Date