HomeMy WebLinkAbout518 Ramah Dr - Applications/Reroof - 02/14/2012Feb 14 2012 5:06AM HP LRSERJET FAX
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,Manning, Development a Tm portatlon
281 N. College Ave P.o. Box S80
Fort Coruna, CO 80524 !�
Phone 970.416-2740 Fax 224-61�14 1
OVER-THE-COUNTER RERMrrS ONLY
This application Lion b to be used to apply for the following perks only (ohsCk all that a 1 OJr Conditioning
❑ Oemoiltion,pnterior non-structural) O Electrical Aiteratlon (not servpi �change) 0 Gas Lighter Gas Log
❑ Heating Unit O Lalwn Sprinkler 0 Mcblls Home replacement =00fing O Sewar Une q P1w jo-volwk
0 Ventilation 0 Water Heater O Water Line 0 Wood/pellet Stove (
manufacturer), must be EPA certified, provide aka, model and
Complsb e11 sppilo bfs information on the application. Incomplete appllcatl na wIII not e a
Application # �% ` >� P c4epted.
For aH9ca use only Date I / I L/
lob Site Address (n?pu/rad) Value of Construction (labor, maoelrlais, pmmt)
Property Owner Name Address City/State Zip Phone
Applicant Name Address city/State Zip Phone
Contractor Lic ;rl (�ZI l 16 Address City/State Zip Phone
' rS JIf bevw P C
Contractor City of Ft. Collins Sales Tax # Are you payI4 taxes here or by report? 13 "ere 0 Report
5WMAw MM&&&Mg~byaamnaaCWff. Are you paying with your trust aceounYT O lies Gk No
Is this a resldendal or_t0pnercial projew OrRaldential 0 Commercial
If residential, Is It: IN Single Family Detached 17 Condo/townhome (single family attached) 13 Duiikx
0 Mufttfamlly (apaMnent) 0 Garage
If eommerdal, Is It: 0 Bank Cl Bar ❑ Church 0 Hotel/Matel C] Medical office O Office O Ratail
O Restaurant I7 Other (explain)
Is this building 80 teats of age or more? O yes 0 No nA* yw flay need to contact N/slvrtc �altan
If this Is for a demolition permit, what year was the buliding c msbucteO
Jf prfar to 1975, you nd# need an asbesaas as wssrnent In subm/t with M& aAWkatfan.
of
*Tf lawn sprinkler/ ow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subeontraetasl list ft cromprny name or dty Of COMM /lcensr s
ElatVIWn Plumber Mechanical Roofer
I hereby adolowledge that 1 have read this application and stabs that the above Information Is complete and
comply with all nwAArements contained herein and city ordinances and state laws regulating building eonstru
permit Is not valid until tt has been paid and Issued.
Appl"nt:
Print Nang
Signature
Date
G I agree to
I know that a
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