HomeMy WebLinkAbout636 Sandreed Ct - Applications/Reroof - 08/07/2014��'+Y} of wa�o; Ott & Y tion
I E CollinC 281 N. College Ave P.O. Brno Sao
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224_6134
®TIER-THEnCOUNTER PERMITS ONLY
This appfiaation Is to be used to apply for the following permits only (check all that apply). 0 Air Conditioning
O Demolition (interior non-structural) 0 Electrical Alteration (not service change) O Gas Lightner 0 Gas Log
O Heating Unit ❑ Lawn Sprinkler ❑ Mobile Horne replacement ❑ Roofing O Sewer Line 0 Photo-voftaic
O Ventilation 0 Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
ufactu
man rer).
Complete all applicable information on the aPPIlcation.
Application # e) (4-05q (03
/or afte use only
incomplete applications will not be accepted.
Date g `7 ` J �
]ob Sfte Addre ss (fesquired) Value of Cots tl (k*w, materiaa, profit)
6 36 YciJ re 9d Cf, R, Coll," .905
2
s $ 3000,00
* Property Owner Name Address
City/State Zip Phone
cy\ der Sq rq
e 2,0y-1-750
Applicant Name Address
'
Clty/State Zip Phone
t,y 115 rd,
Lovelod co 0s37 CC7-'1
Contractor Uc # Address
City/State Zip Phone
lerc 5 lb2611 -) .SQ
Contractor City of PL Collins Sales Tax #
Are you paying taxes here or by report? Here 0 Report
5Ws laarntanber & rendfed by a0 cm"Cibm
Are you paying with your trust amount? O Yes of No
Is this a residential or commercial project? Q9 Residential ❑ Commercial
If residential, is It 1% Single Family Detached O Condo/townhorne (single family attaot18d) O Duplex.
❑ Muldfamity (apartment) ❑ Garage
If commerdai, is it: ❑ Bank ❑ Bar 0 Church ❑ Hotel/Motel O Medical office 13 office O Retail p23
O Restaurant ❑ Other (explain) U,I�
Is this building Soyears of age or more? O Yes )dNo Brpvw,).WnwfAeeatL7avitaaHbAmfcPnmwMbbn
If this is for a demolition permit, what year was the building constructed?
lfpffnr to i975, you will need an asGesws agent to submit w1Gh this BAOMdM
of work
*If lawn sprinlder/backflow preventer, must fist lKwised plumber. If first-time A/C, must list licensed electrician.
Subcontradbong else aw company name or city of Ft coAm Imam 0 > r � �oo� Ofl►er
Bedrldan Plumber NledtaUl*ai
I hereby acivuwvle ige dub I ha1e read this appr and state that file above information is conloete and correct I agree to
onmW wmn an requirements contained herein and city ordinances and state laws regulating building eonsbuction. I know that a
penult is not valid until It has been paid and Issued.
Print Name:j �• r ry l s1 i✓i 5egnatu DSO —