HomeMy WebLinkAbout2718 Blackstone Ct - Applications/Reroof - 11/08/2011Plannln& Oewtlopmaet i Traneportatlon
281 N. College Ave P.O. Box 580
Rat Collins, CO 80524
Phone 970-416.2740 fax 224-6134
OVER-THE-COUNTER PERMITS ONLY.
This application Is to be used to apply for ttee %liewing permit* only (ohack all that apply). C Air Conditioning
Cl Demolition (Interior non-strueturaq :3 Elsctrleal Atteratlon (not service change) O Gas Lighter ❑ Gas log
❑ Heating Unit 0 Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing Cl Sewer Une O Photo-voit,aic
0 Ventilation O Water Heater ❑ Water Line ❑ Wood/Pellat Stove (must to EPA Certified. provide make, model and
manufacturer),
Corniblew all applicable Information on the application. Inca., plate appiketions will not be accepted.
Application * e 1110 all(A Dabs--_ -- _ _ 123. 5 5
raw ante roe only
Job Ske (�ed� /)� I Value of ConRtvetion (labor, materials, profit)
K C
e-27
Property 0 Na Address
Ctty/State
Zip Phone
.Applicant Name Address
City/State
Zip . Phone
Contractor Lk: p Aadre s
City/State
Zip Phone
Contractor City of FL Collins Sales Tax
Are you paying taxes here or by report? !a Herr Cl Report
its car mmaeraftvtyedoyae'ca*=WM
Ar'e you paying with your trust account? ❑ Yes Jill No .
Is tf;ls a residenttal or Cpmmerosl project? $lRasktential O Commercial
if residential, is R; 45 Single Family Oe,tactled. Cl cmdo/tnwnhome (single family attached) O Duplex
O Mukifarrilly (apeftwit) ❑ Garage
If comnierClai, Is It: O Bank 0 Bar C3 Church Cl Mcftl/Motel O Medical office O Office i] Ratall
O Restaurant O Other (explain)
Is this buikling So yaws of io" or mac? O Yes A No Arye4 yew may need to cantad tastfi* Au wvadan
if this Is for a damolltlan parmlt, what year was the building conobvi2ed? I
If prkrr to 1973, you ** owd sn a reacts asWsartwnr to subntet wllfl this dololleaVon,
Description of work
IE
71 f own sprinkleribscleaw grrmnAN. must lid Ikeneed plumber. If first-time A/C, must list hcwftd elftArldan.
Subcontractors: Ltd dre CA7V nyname ar cry ofR co✓Ihrs Aurae t
elecv.ldan Plumoer Mecnsrrui aoorsr
I herd admowlefte that I helve need this apppliccation and state that the above Information it complete and correct. I agree to
complV with all requirements contained herein and city ordlrwxm and state laws regulating building construction. I know that a
perink to not valid wall It h" been Wed and lewtad.
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