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HomeMy WebLinkAbout2950 Neil Dr - Applications/Reroof - 06/06/2012 (2)•00/06/2012 03:31 FAX 1a003/00a City crF Collfn$ Planning, Deveilopn ant a Trmaportadjae 281 N. College Ave P.O. Boot 58d Fort Collins, Ca 80524 Phone 970.41&2740 Fbx 224-6134 OVER THE -COUNTER PERMITS ONLY Thla application is to be used to apply for the following permits only (oheok all dud apply). 0 Air Conditioning El Demolition (Interior non-structural) ❑ ©ectrloal A.Aeration (not service change) 0 Gaa Lighter 0 Gas Lop 0 Heating Unit 0 Lawn Sprinkler 13 Mobile Home replacementt [Roofing 0 Sewer Line D Photo -voltaic Q Ventilation ❑ Water Heater 0 Una ne ❑ W=4 etlet St&a (must be EPA certified, provide make, model and manufacturer). Complete all applioabie informaN non the application. Inoompleft applications will not be aacvptsd. Application # I o Date Cr/L VAa . -I ror &rr"LWMtl >�+ site /lddreae n value of construction (labor, matvtals. Prollo �ySp A1ei I Orr v�,i�s j�s� , S, 7A1�.00 Property Owner Name Address City/Sbte 2Ip Phone iir+ iro v� ►�a iJ�^.t 300I Got-e i 4L 4 (014, C0 rbrja 47v-377 Appilow t Name Address city/Stabs Zip Phone �, F - Gontractor UC # -! Address ae�/��eo MP l Phone ' E l rn,� ; ! C 9 Contractor City Pt. Collins Sales Tax # Are you paying taxesthere or by report? Here 0 Report .cabs wxnrandarlt bya Gvr afm 4121-7 - Are you paying wlthiYbur trustco acunt? 0 Yes �No To this a residential or commetClal project? XReSldelftil G Cbmmerdal If residential, is it: ID Single Family Detadted XCOWgftownhoine (single family atmched) O Aupkac C3 MuitiFamoy (apartrrwm Cl Gwage If commercial, is it 0 Bank Q Bar O Chunir 0 FiotelfMotel IJ Medial oflioe 0 011ke O Retas 13 Restaurant Q Other (explain) is this bullding go years of ago or mors7 13 yea No 1T yid you may need to corrbac h2ft l: Pnw&wbbq If this Is for a demoiltfon permit, what year was the building M000%eted? lipn r to 1973, ym wU/nead an asbaWs aassiRmiat 6o s0ni R wft this aAmilobba Description of work - c , Ql • *If lawn s prinklelybaddlow Preventer, must.fta scansed plumber. If firm A/C, must list licensed electrician. SubmdraMms Liss bhBfxpmQenY/AT/il®OrdllYafR Btwrtse # mvariowL. M mbar mahvicaL. Roofer _ Other I hereby ad7amedge that I have read this application and state that the above WarMation is opmplete and mrraCL I aorta to =,A* whit all rer ownerft conisho t>wr and dty ordnwx= and suw laws regulating builmrtll consti lion. I krww V" a permit is net valid until m harm been paid aad lsmami. ' . Prirtl idarne: OVUA, (.oVL6, W