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HomeMy WebLinkAbout2219 Stoney Pine Ct - Applications/Reroof - 08/20/2014UVbK-1 flit-UUUN h LK r1hK 1 lb UNLT This application is to be used to apply for the following permits only (cheok all that apply). ❑ Air conditioning ❑ (Demolition (interior non-structural) 13 Electitcal Alteration (not service change) © Gas L.Ighter ❑ Comas tog Q Healing Unit 13 Lawn Sprinkler U Mobile home replacement � Rooting 13Sewer tine 13 Photo -voltaic 12venilation 0 Water HSa;tAr Q L+-ter Line 0 -011bodIF ellet Stove (meet be EPA eermted, provide make, model end manufacturer). Comulote all applicable Information on the application. Incomplete aDnlloations will not be accepteC_ Application. ([' Date For ofte use only Job Site Address (rzyulrrad) Value of Construction (labor, materials, profit) aAtg �•� P-tn� �+ '% A o Property Owner Name Address CityJstate Zip Phone Applicant Name Address awstate Zip Phone cl W - pl-r T-,PW le ReeCi T yiC alit W. Tr;ib a P'm co $oS�S �.o-1-ciao a canlracto( Address dwstaw Zip Phone Contractor City of Ft Collins Sales Tax # Are you paying axes here or by report.? a ere n Report. sa/,u tarnumw tomwphrdbyeUawrl vM—.a Are you paying with your trust account? Ii3"Yes O No Is this a residentiai or CM, merdal prci)=7 W Residential 13 Commercial It residennal, is it: (ff Single Family Detached ❑ Condo/tawnhome (single family attached) E3 Duplex Q Niultifamliy (apartment) ❑ Garage If commercial, is it fl Bank Q Bar ❑ Church ❑ HotelJMoiel ❑ Medical office ❑ Office ❑ Retail 0 Restaurant ❑ Other (explaln) Is this building so years or age or more? ❑ Yes O No ff)es, yWnrayn2=-d trt tarrtad'H&tbdcPresan+ation If this is fore demolition permit~ what year was thk'bullding constri e0- ?+`,prior to 1975, YOtJ w/111reed'arr ashesMs ass>'ssmrnt. to sxrbmit'xtibi ibis application. Description ufr lawn sprin1cWtiac11low preverrter, must list licensed plumber. If first time AIC. must list Ilcensed alecbician. Subconiractors: UsClh�Cr7mfraltynemeOl[7ZyOfftLOillnSifC�Y1s2,:. ElerWdait. Piertber Med'larikal Roorar R— 1$67 Other I hereby acimowledge that I have read this application and siaba that tha above Inib"Atioa Ls complete and oomect_ I agree to comply with all requirements contained herein and idly ardinallms and slate laws regulating building oonstmcdon. % know that a permit is not valid until it has been paid and issued. l Applicant! �'`.i.d,� yl Date Prink Hnme rLnn--A `e � InYF i VtQ S si®rmtute_ J,_ rr,_ -- r