HomeMy WebLinkAbout5433 Apple Dr - Applications/Reroof - 08/21/2014OVER-THE-COUNTER PERMITS ITS ONLY
This application is to be Used to apply for the following permits only (check all that apply). C1 Air Conditioning
❑ Demolition (interior non-atructural) ❑ Eleotrioai Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
17 Heating Unit O Lawn Sprinkler O Mobile Home replacement Roofing ❑ Seviwer Line CT Photo -voltaic
❑ Ventilation 0 Water Heater n l ftW Line ❑ WeodlPellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete ail applicable information on the application. Incvmplste applications will not be acaeptad.
Application # .R�! dLai_ Date
For of m usv only
]ob Site Address (ramIrad)
Value of Construction (labor, materials, profit)
5933 ie. br.
ao
Property Owner Name Address
Gty/State Zip
Phone
ARRliont Name Address
Ciiy/Staitz ! Zip
Phone Q -
F ��bie P.�C z,r� alp w. T'rilb Rk FIC 46 S6sa9-
;La-r-aaoa
Contmcbof Address
/state Zip
Phone
Contractor City of it Collins Sales
Are -you paying taxes here or by report? evere ❑ Report
saleslarrrlMrbBrlsra}teGedayPllCWrbBefarS
Are you paying with your trust account? 2Yes
❑ No
is this a residential or mmmerdW prnjErt? Residential Q commercial
Tf residential, Is it Ll single Family Detached E3 Condo/townhoma (singla family attached) ❑ Duplex
Multifamlly (apartment) ❑ Garage
If commervai, is it: 0 Bank ❑ Bar ❑ Church O Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this buIIding so years of age or more? ❑ ups a No If yes< yoVmaynaad to avn!a&H&WcPresewffa u
if this is fora demolition perrrilk whatyearwas thr:•bullding mnstnickee-
ffp►iorm 1973; you will need -an as&m'h9 as seamranrin subywtxgbL fftisepivAZ2ffon.
Desaiptlon of work
*If lawn sprirader/baddlow pneuerrter, must list licensed plumber. If first-Ilme A/C, must list 110i nseed elerxrldan.
Subcontretars: L&t Me cwWany rmme or04, aFR Ca ftshbmm A
Eleclridan Rumber Medianlesl rtoofeJ � t �+ 7 tether
i hereasy adorowledge thatl have read this appilcation and state that the above Information is complete and correct. I agree bo
Comply with all requirements cantafned herein and city ongnan[as and state laws regulaUng building construdicn. I knowthat a
permit Is not valid until it has been paid and issued.
Applicants A
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