HomeMy WebLinkAbout1518 Mathews St - Applications/Reroof - 07/18/2014VER-THE-COUNTERPERMI ONLY
'This application is to ba usad to apply for the fallowiiig.permits,only (check. all that apply).,O Air.Condliioning-
b Demolition (interior non-structuMI) 3 Electrical Alteration (notservtca change) Cl Gas Lighter, 13,Ges,Lng :
17 Pleating Unit ❑ Lawn Sprinkler Cl Mobile -Home replacement' )I Rooting El Sewer Line.'1TPhoto-volfalc
e Ventilation: 0 Water Heater Q Water Line - 0 Wood1Peilet Stove (mustbo EPA oertifisd, providerrtake, model and
manufacturerj_
Complete all applicable infor
ma
tion
on the application. Incomplete appileationswill .not be accepted:
Application # —� "'T c ��i- 'Date
For of e iise only
Job Site Address (requlred)
Value. of Construction (latwr; materials, profit).
f51$ 1�I a�-hews 5-'I.
(07`�C�., do.
Property Owner Name Address
City/Stair:
Zlp 'phone
-:3a San
Applicant Name; Address
'City/State
.Zip
Phone qi
A r�ab e 'boo T.v,c: atrl W-- i- lb ,1ZcQ
FTC ::ct SoS�S..
ao-t-�aoo
Contract3 r Address
, ty/State
Zip
Phone
-5 044AE
Contractor City of R. Collins Sales Tax 4,
iAre you paying taxes here or by.report? 12111
• ❑ Report
Solesr2xnumberlsre4edrcdDyr+i/ronrmcC7rs
Are ycu paying with
your trust account? Sd ,Yes
Quo
Is this a residential or, commercial project? (&Tlte,idential. Ci Commercial
If residential, iS it:' W Single r-amlly Detadied [3 Condo/townhame (single, family, attached) 7 Duplex
i3 multifamily (apartment): 13 Garage
:If commercial, is.it: ❑ Bank Q Bar. ❑ Church ❑ Flosl/Motel ❑.Medical office ❑ Office 13'Relmll:
❑ Restaurant... 0 ether (explain)
Is•this building so years of ago or more? O Yes, -❑ Nn iiy4 yo{imaynecd .rb CM!MCtffislvriCPresc vatloii
:If this is for a.demolitiori perEriit, whatyearWas the•buliding consbrueted7••
,rFP1fvr tb 1975,'you will ncod an asbssiw assessmenf ry su6mJt wRh this apPOration:
of work
*''If lawn sonWer/backliow prevenhT, must' llk licensed plumber. If.,fin l-time A/C, rnust list licensed electrician.�, Yts.
,. • OF/w
Subwntract=5: W 11W camwnyname aro,lyafR CoNns.Acaise. A
'EIeCflfclan _ Plumper •Mecliaratol .. Roofer' R= �1559 Other .
;.I,hereby acknowledge that T have read this application and state that the above 3nforrnatlon iscOrrpiate and correct: agree to
eurnplywlth all requirements contained herein and. city ordinances and state la%4s regulating building con9ftctlon. I know that a
permit is not vad u lihtil it has been paid and issued:
;.Applicant:; jj�{
print Name: r +y