HomeMy WebLinkAbout2803 Des Moines Dr - Applications/Reroof - 08/31/2011 (4)Plaenhis Development 8► mution
281 N. College Ave P.O. Banc 58b
Fort Coliirss, CO 80524
Phone 970-416-2740 Fax 22+"
OVER-TH&COUNTER PERMITS ONL
This application Is to be used to apply tor; the 1110116YMng permits only (check all that apply). 0 Air
O Demolition (interior non.otruclaird) ❑ Eledrical Alteration (not servl change) CI Gas Lighter C
0 Heating Unit 0 Lawn Sprinkler ❑ Mobile Home replacement URooflng 0 Sewer Line 17 P�otk
0 Vendladon ❑ Water Heater E3 Water Line 0 Wood/Pdat Stove' (must be EPA cwdned, provide mr
manufactuker).
Complete all applicable information on the application. ineompfets applications will not be aloft
Appiicatlon Date I 1
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Property Owner Name Address city/Sulba Mp t
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City/State Zip
Phone
Contractor Address
CftY/state Zip
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Contractor City of FL CAM Qcs Tax P
Are you paying twin here or by report?
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Are you paying with your bust account? C Yes
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Is this a residential or commercial project? fi� Residential 0 Commer®I .
If residential, is it ❑ single Family Detached 0 Cando/townhome (single f * attached) 13 t�rpl
10 Mull famlly (apartment) 0 Garage
V commercial, Is it 0 Bank 0 Bar 0 Church D Hotd/Mobei 0 Medical office CI Office 0 R
O Restaurant O Other (90ain)
Is this building 50 years➢ of aye or more? A Yes O No Il)e&yoamayneed to cvnfacahtlsaartc
If this b far a demolition psrmlk what year was the buUng con Mudsedt
lrptkr to 1974 )w *0need an aaa6asias asse nvnant to sre5mdt wM Mb-a plAsain
Work
*If lawn sp nkW/baddlow presenter, must U 11waW plumber. If flrst-ume A/C, must Rd tkensed deWda'h.
subtonaaetMrN:ListthearmpanyRArrrearaIYcfRCDMiZF 2ffM#
Seam F Plumber MKhwJmL. Roofer s-aG3( f Obi
I hereby advroMAedge that I have road this appik dion and state that the above trfonnatiion is complete and
ownply with all requirements; eontiAlned herein and.dty ordinances and state laws regulatirhg building consbu
permit is not vW W until It has been paid and hared.
APP��
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