HomeMy WebLinkAbout4925 Clarendon Hills Dr - Applications/Reroof - 08/11/2014]ob Sit1B.Address (requ/mod)
Value of Construction (labor, materials, profit) ...
�q ef (� 0nC-,) C�C1
. ...
Property.Owner..Name
-.Address . .
Gt.Y/State. .. ... .......... ;pp .. Ppone
Applicant Name
Address
Ct ytstate ' Zip hone
Contractor
Address
City/State .t zip Phone ,3
Contractor City Collins Sales Tax
#
...Are you paying taxes here or by report? 0 Here 0 Report,.
:SaAw&wnimbera iredb aNcanbacinrs �--
ii�3Cca-`j
Are you -paying with your trust account? 0 Yes ❑ No
..
Is this a residential or mercial project? XResidential O Commerdal
If residential, is it:. Single Family Detached Condo/townhome (singie family. ottad� O Duplex
0 Multifamily (apartment) 0 Garage
if. eommerciai,.is it: - 0 Bank ❑ Bar .0 Church 0 Hotel/Motel '0 Medical office 0 Office 0 Retail
0 Restaurant ❑Other ( i
Is this building 50 years of age or more? ❑ Yes o If yes, you may need to contact H/stmfc Pr�t/on
If this is for a demolition permit, what year was the building constructed?
Ifpior to 1975, you will need an asbestas assessment to submit.wffi this application.
of work
*Jf lawn sprinkler/Cack iow preventer, must list floen§4d plumber. If first time` C, must list licensed electridan.
Suiioon3racbors••.List tbe company name or.O'ty offt CoNlns,/kerrse 0 ..... .
Electrician Plumber Medianical - Roofer Other
I hereby acknowledge that I have read this application and state that the above information is complete and correct I agree to
comply with all requirements contained herein and city ordinanoes and , state, laws regulating building construction. I knovr,tltat a_
permitls not vaiid.until It has Been paid. and Issued._
Print Name: is_�`i 7� r^�(1� >f;�(� Signature C ..t)abe