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HomeMy WebLinkAbout5220 Boardwalk Dr - Applications/Reroof - 04/02/2012 (3)04/02/2012 10:29 9705930124 GOLD ROOFING INC PAGE 18/24 OffPd G e7 - 2 � �ar06� Planning, pevEaloprnentt & Transportation CAY, of 281 N. College A►ve P.O. Box 580 Flirt Collins Fort Collins, CO :80524 �— Phone 970-416-:2740 Fax 224-6134 OVERmTHE-COUNTER PERMITS ONLY This application is to be used to apply for the following permits only (check all that apply). ❑ Air Conditioning 0 Demolition (interior non-sttucturap 0 Elect ical Alteration (not service change) ❑ Gas UgMer ❑ Gas log ❑ Heating Unit 13 Lawn Sprinkler ❑ Mobile Home replacement )(Roofing 17 Sewer.L'rne 0 Photo -voltaic ❑ Ventilation ❑ Water Heater ❑ Water Line 0 WoodlPellet Stove (must be EP'A certified, provide make, model and manufacturer). Complete all applicable informar-^ nn the application. Incomplete applicadions will not be accepted. Application #�•(v2bli`f`i 'Dated For ware um any lob Site Address (Ahvukmd) JrZ2U L3oQrAiLt�'.•/�. ba'Y. �" �D Properly owner Name 6'Ma Crd- 7 Address 0,/j P am , &!ryj'j.g 15`6-A1, 6/h Name Address Value of Consthtetion (labor, mabulats, profit) $ g, jsy� City/State zip Phone Gty/State Zip Phone contractor uc # Address aty/Statie Zip (974)Phone C�DId &4WAX 593 : 'a Contractor City of Pt Cbtns Sales Tax # Are you paying taxes he re or by report? 1; Here Cl Report warn - & rew&W bya#cw&3cMm Are you paying with yowrbug aomunt? ) .'es 0 No Is this a tesldentYal or commercjal project? ❑ Residential A"Commerdal If residential, is It ❑ single Famsy Detached ❑ Condo/townhome (single faml / aMxhad) ❑ Duplex. ❑ Multifamily (apartment) ❑ Garage If commercial, is it: O Bank ❑ Bar ©9udl ❑ HoteJ/N�oael C] Medical office office ❑ Retail 0 Restaurant Other (explain) is this building 50 years of age or M01e7 17 Yes �f4 1?`yes, you maynHCd LnntaCt �SiG Presrsvation if this is for a demolition permit, what Year was the building cmistrudad? Ifprjor to 19n yw w19aeed an asbesfas azesw mt'tn submit with ffi s APP&BtOr. Description of work *If lawn sprmider/baddlOw preventer, must 21 rko d plumber. if fmx-Ume A/C, must Gist 6tensed electnaan. Subcontnacbaiw List lire compiaw name or t7iy of COON fAwz!Ae i Pl<unber Sectridan.pied dal_ Raafa IC`t'3�] Otlter Thereby adamwk4ge that I have read this apAlitatim and state that the above mformado n Is complete and coned:.. I agree Ito comply with an reauinmmnts eorfmied herein and city orr9nances acid stake laws re9tdatn 9 lnnldi V 0XISbutim. i know but a permit is not valid antg it has been paid and issued.AMUMM � a -M