HomeMy WebLinkAbout303 Tiflin Ct - Applications/Reroof - 11/02/2011Nov 02 2011 8:359M HP LRSERJET FAX
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�oPont Transport4tlon
Fort N. C*sege Ave P.
0-4O. Box silo
Phone 97 , CO 80524
16-2740 Fax 224-6134 1-~7 5�
?'Isle appllcatlorh I: to be used to applfor wU1VTER PERMITS ONLY L
0 demolition (Interior non-etnsct Wirt Penhitrr only (check all that ❑ Hag Unit ❑ oral) O Electrical Alteration (not 8en a ePPIy). O Alr Condfllonln9
❑ Vantllatl Lawn Sprinkler ❑ Mobile Horne replacement L9'f� ) C3 Ga$
on 0 Water Meaner ❑ Water Line ❑ oofin UOhter ❑
cae Log
menufAClUr6r). Wood/Pellet Stove g ❑Sewer Una Q Photo-vottek
(muat be EPA certified, provide make, model and
Complete all epDllcstbia inforn,arlr... w_
Appltiltlon #
OVER-TH
rw aMce use ary
]ob Site Address (fegvrrred)
tea ePpilCatlon. Incomplete is"licatbns will not be aooePted
Date
Value of Construction (labor, mateeals
Property Owner Name Address
Clty/State Zip Ph9ni
Applicant Name O OS 2.'S 9
Address Clty/State
LD Phone
Contractor Lic # 1Z Z ( Address
City/Stele Zip Phone
11 ,
YY.�riihrc �7:n c .. i
Contractor City of Ft. Collins Sales Tax
selasrbrrrAre reee,an�yg,ar��M you paying taxes here or by report? M Here Are you paying with your trust account? ®'S'es o 93 R No
epo rt
Is this a tialdentlal or co n"gollrgal project? Residential Ci Commercial
If residential, Is ngfe Family Detached ❑ Condo/townhome (single family attached) p Duplex
If commercial, Is It O Multi}>amlly (apartment) Q Garage
CI Bank CI Bar ❑ Church ❑ Hotel/Motel ❑ Medical office O Office ❑ Resburant C1 Other (explaln) ❑ Retail
Is this building SD yhaene of ate or more? O Yes 13 No 1!`yes, yar, nary need envrtact h7s�rAc p y ryada,
If this Is far a demolltlon permit, what year was the building constructed?
!f pnor to 1975, You wN/need an anent In .subm& with thLs bivp/Icabavr
Description of work
*If lawn !WrW r/Iaclrtew prMenter, must list licensed plumber. If first-time
Subeontrachm. L/ar the Corn A/C, must list licensed eiectrldan.
�r+Y same or Guy of Co/brts /krnshe sr
Electrician dumber
fMetnerNcal�`_ Roofer
�_ Other
I hereby adohowledlle that I have read this application and state that the above information Is complete and sorest. I agree m
comply with ell r8quft7wM contained herein and city ordinances and state laws permit Is not valid until It has been paid and Issued, regulating building construction. t know, that a
Applicants
Print Name -true ,,,. Signature