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Home My WebLink About1908 Sheely Dr - Applications/Reroof - 05/09/201405/01/2014 12:26AM FAX 8704938868 C. F 6A C o 4 1 n ACC ROOFING INC IM0001/0001 Planning, Denelopownt OL Transportation 281 N..Colteae Ave P.O. sox 58e MIT t onins, G0 8052.4 Phone 970-416-274o Fax 224-6134 OVER-THE-COUNTER PERMITS ONLY T'ee I qv. 8S This application 1s to be used to apply for the following ❑ Demolition (fiterfOr ror-structural) ❑ Electrical Aitentt►on (knot ervice haheck ang ) all 13 Gas UUght r©13 Air Gas Conditioning ❑ Heating unit M Lawn Sprinkler ❑ Mobile Home replacement ❑ Rooting D sewer Line D Photo -voltaic �El nutacation D Water Heater. Q Water Una rl w��gQt � p„unt Lm orA cermea, provide make, model and Complete all appllcable Information on the application. Incomplete appllcatione will not be aCCepbad. Applica"on # �4Q22�5 Date�5 -1-19 . FOP o� else only �"^`�""� 30b Site Address 15102, 5 {� ��>�� ^^ Value of Co Q tampion (labor, mabariels, pror�t) Property Owner Name" Address city/state 2; � Sheet ' P 97r one .�i� ..�tY [�� Cr�g�lU4 Applltent Name -�-tt�` i gd�re�L 1 �^�o�n � p Phone � q70 11L� Contractor l.ic 1!� r1 n C'�- Ad/r 1/.. I7 . � city/state ZIP _Phone Contractor City of FIS-4ollins Sales Tax # 0140vi Sakstarrinan a bya0 m Are You paying taxes here or by report? Nere Report cco Are You paying with your trust aunt? Q es No Is this a residential orrMsiullftmily,;(apartment) memiat low �I Residential O CDMMerdal If residantlai, Is it: ngle Parrtiiy, bebtchl , D Condo/towilhome (Single family attached) 13 Duplex 10 Garage If commercial, Is It: D Bank d ear O Church 0 ibbei/ OW ❑ Medical office 0 office 0 Retail Cl Restaurant: O Other ( ) Is this budding 80 years of age or. more? t] yesNo ,l)Wy, wu may need co mne&etMAto v Awwvabbn If this Is for a demettdon permit, ;what year was b Ikling construcbad? 1i`'pmr to ?975, yell wl/l need an admsios assessment ro sabm/r mw W& aAP/rwff= *If lawn sprinlder/baditw prevsntar, must list licensed plumper. If firs"me A/C, must list flcensed etectrlclan. SubC60traatorsr LN Me caWwW tome or aty ofpt C0#AV aM ,0 @ plumtrer Mechankal- _ Rao* Odd I hereby admowledge that I have mail this aDplitatton and state that: the above inf Trianon is complete and correct I agree to Compy With all requirements contained hereln and city ordinaries avid state laws regulating building eorlsbWdon. I know that a Permit is not valld until R has been paid and iswed. ApplNCent: , Print Namer;] it Signature Date 7 .