HomeMy WebLinkAbout319 Bowline Ct - Applications/Reroof - 11/15/201115 11 12:24p FM Roofing Inc.
Fort Collins
1-970-221-8526 PA
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00 Phone 970-416-2740 Fax 224.6134
OVER-THE-COUNTER PERMFM ONLY
This appocatlon is t o be used to Iq*ly for ttw.j0^a7 � ( an du t appl�. D Alf CondrbGillffg
❑ Dernolibn (erten0r non•structura q [7 EMddcal Ai oshon (not servke change) ❑ Gas Lighter ❑ Gas Log
❑ Hoeft Unit 0 Lawn Sprkdder 0 Mobde Home repiacernwt YZR00ft ❑ Shtarer Line ❑ Photo-vo[baic .
❑ Ventitadon ❑ Water Heater .0 Water Line 0 WoodlPellet Stove (must be EPA oactilied: provide shake. model and
mamdacw r). wm not to accepted.
conmAerte all appBcabls infix, on on the ap acation. buxx &" e�
catipte � _ Da/1-1 S—Il
Far aolbe Lee &* - '� ` _14-)
Job Sfte Addre w (h quhm) Vabue of CorrabvCdon (labor, materials, lam) j
? I q �acv�?-- L — ��� i �, �rI
Property Owner Narne - Address
City/SWR Zip Phone
a: tail r . uE
A,ppr�rt Name Address
CitYl� Dp Phone
Conbadar Lic # - Address
Cly]Statie zip Phone
FM Roofing Inc. R-400 1629 S.
Lemay Avenue Ft. Collins, CO 80S25 970-221-1388
Ca odor City of FL Cogs Sales'fac
Are Ym PayM taxes there or 6V report? ® Here ❑ Report
Sat�soarnre, lcrs+quFadbya4m�eaarn2 18S96
Are You paying with your bust account? ❑ Yes ERNo
is this a residential or aommerdal pnv..led? OAReslderfial 0 Conrnerdal Q
Duplac
If residue, is it M9ngte far„ a y Detached 0 Candolt> wmhorne (single bn* atladhed)
D MubUmW (apt DGarage
if oanrrerriair is ie 0 sank 0 Biv 0 church ❑ Hotel/Motel 0 Medical dike 0 Office 0 Petal!
❑ Restaurant ❑ Other (expW)
is this building so years of age or 3 h om2 D Yes O No -r)e* ynxr flWne d W mntadMUw cPratarre0=
If this is for a denvWdoo pew s hihat year was ibe bWk§M oons ructed?
.1fpniar m 19n yw w5 ae+edan asa iam;Ms aaessnMtW s~ nth iris apptivffm
Desaipbonofvrork v,jiNu %k��LL1*1(V) ! h11 Mil rW.jw I(krvthIue,rrV,
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*9 lawn spriniderybadQlow praft-tw, roust list lioensmd ph8ntw Ifftst-tune A/C, must list Oceased elacbidam.
Sabaorrtradiwn l&VvcwaaWmacear6Wdrf'CoMMAerse0
F]e San Plu bw-
I hereby aduhowWW that I have read this appliicadmi and state that the above efa rabon is ONTOebe and caned I agMe to
comply with au re**wmds aNiWmi hares and oar orc& saes and state laws reg<#aMv bui7dirh9 cm sftucbm I know thhat a
pernd t In not valid untH It has bee m paid and leaned.
APPIllCaft
Print Name: Sighaature tie