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HomeMy WebLinkAbout208 Cleopatra St - Applications/Reroof - 01/25/2012Jan 2512 02:20p p.1 i Planks,, Development & Traiesporb&on 281 N. College Ave P.O. Box 580 Fort Colfins, CO 80524 Phone 970-416-2740 Fmc 224-6134 OVE WTH&C OUNTER PIER US ONLY This application is to be used to apply for the following permits only (check all that apply). ❑ Air Condd cirimg (7 Demolition (m ledor nonstructural) 13 Electrical AlberAon (notservice Change) ❑ Gas Lighter ❑ Gas Log O heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing 0 Sewer Urine ❑ Photo -voltaic a Ventilation 0 Water Heater ❑ Water Line ❑ Wooditlfet Stove (must be EPA certified. provide make, model and imanufacturer). Complete all applicable Information on the application. Incomplete applications will not be accepted. APPif[iIEiOR # Date rbraffwzww. 81200 2 lob Sile Address (taeutr� Value of Con6trudion (labor, rtateriaC� profit) 'properly Owner lam Address CW/State Zip Phone q7V n. f arWV) f ✓�,,; ,ram -:: 2 5 Apprmant� Address (�y/State zip 14 Phone rr I r,Co 0 0 f 1 `Can Address Cty/State Zip Phone j - r - t51//d -50 'Contractor City of Ft Coll his T # Are you p6ying imaes here or by rWort ere ❑ Report s.�srarnurn*-r,rreVzftdbjrizlY Are you paying WM yourtrtut acamU?YKYes Q No IS this a residential or co nmer;:W prgectt Residential ❑ Commer®1 p Duploc lif residential, is it: �Id Single Family Detached tl Condolwwnhome (singlefamily amdu%D ❑ Multifamily (aipartriat) © Garage ?If commerdal, is, iti O Bank ❑ Bar ❑ Church ❑ HoWfMotel ❑ Medical offke 13 Office ❑ Retall ❑ Restaurant ❑ Omff (ehgnlatn i Ls this building 5o years of age or more? O Yes If jieg youmayneed (a cantacthGsh7vicPreservaSan ;if this is for a demolitforr penadt what year was; the building constructed? �priarm 1973, ynu uo77nee+dan asbe�s ases$nenttn wWnrtwitli b5ls ap�adr�ffon. of work lawn sprenkler(baddiow pre wnw, must list ltoensed ptemnber. If am -time A(C, must list ken ed elechiaan. tr ttlre cor4pvWname orgy of CblinsGamm 0 Phaober fiedwid di Rcofsr—T hereby admowledge that I have read this application and state thatthe above WMnatton is omrplete and correct Z agree to )mply with an re:eirrl<erreim mined herein and aty om%3r aes an$•sate faws regulating building mn6huttion. I know OM a ermit is not val"ed until it has been paid and issued. J r f !'