HomeMy WebLinkAbout7108 Avondale Rd - Applications/Reroof - 05/04/201205/04/2012 10:35 9702669123
F rt Collins
DRENNEN CUSTOM CONT
PAGE 01/01
Planning, Development lkTramportation
281H. Coilege Ave P.o. aox 5W
Fort Conine, DO 80524
Phone 970-416-2746 Fax 224.6134
OVER-T IEwCOUNTER PERMITS ONLY.
This applio8tion is to be used to apply for the following permits only (check all that apply). ❑ Air Condidoning
n DemoM ion frnierior non-structural) O Elechical AlberOdon (not service Change) ❑ Gas Ltgtrter Gas Log
❑ Haatiog Unit Q Lawn Sprinider, 17 Mobile Home replacement JE Roofing ❑ Sewer Line Q Photo-voltaio
❑ Venb'lation ❑ Water treater Q Wat®r Line ❑ Woodipellet Stove (mast be EPA certified, provide make, model and
manufacturer).
Complete all applicable information on the application. incompiete applications will not be
Application #hk 2 W I Date
kr office use only
sob 3 Addrm lre014 Value of Corn on (labor, materiels, profit)
'710 4 /0*,Yj :;r RA. 0a, 700-00
property Owner Name Address City/state ap Phone
q7a.
ea r T , l'r.,yn 2/0 Ayo�1r11 e� ! � F�,C'olC��vs CDo &�sa� v�o
Appflont Name Address city/State ZIP Phone
T)ge C-LtSi fs Cr�n� RAaTWG - , s �lQa2 f-v-099
Cantracbor Address city/state Zip Phone
Contras Qty of FL Collins Sales Tax # Are you paying taxes here or by report? *gHere 0 Report
SAW tax monberAFra0ybyar Are you paying with your MM ac=rit? XYes M No
Ts this a residential or aommMCW praject? We57dengal O Comm
if resldenwi, is t 'Jfi;ingie Fan* Deuo& ❑ Condotwwrthome (single famlly attached) 13 i3upiex
E3 hiuMmiiy (apaftwx) E3 Garage
If commerciai, is it: C) Bank ❑ Bar la Church O Hou*WoW O MedM office 0 Office ❑ Retail
❑ Resleraant Cl Other(e)plain)
is O is building 50 yaws of age or Mort? Q Yes ONO If per, yCr/ ray ntsadW Ganbct Xlstav�c Prepenatran
if this is for a demolition parmik, What year eras the building aft
Ifpniartn 1973, yvu rv�nePd do a arrl' m suWnit w�i tlrlsappll.
*if lawn sprinider/baciftw prevent, must list kw"d pGrmber. If first-1kne A/C, must risk 5omand eiedY an.
subcnatrachx= List the cnrnp�y,z a or L7Ly of R (bllJns
eedritsan Plumber Nedra ' RwW dater
I hereby adawwledge that I have read this appilmdon and stafia that the above irdormaHon is Complete and correct. I agree to
comply wim all r+F quin rnents contained herein and city Ordinances and state rows regulating building omisbuction. I know the a
permft Is not valid unt l it has been pall and issued.
Applicant
Print NOIne
5tgirtrbtne Late �/4 T`��—A---_