HomeMy WebLinkAbout506 Spinnaker Ln - Applications/Reroof - 08/12/2014wig 1691Wn0lF91 l %0g6FWaV 0 Eaa® @ aa8tl@®@@ FiiB!@9ati9ile@
This appilostion is to be used to apply for the following permits only (cheek all that apply).13 Air Condl`ttoning
❑ Demolitlon (Inf arbor non-structural) U Electrical Alteration (notservice change) O Gas Lighter Ci Gas Log
a Heating Unit 0 Lawn Sprinkler I] Mobile Home replacementRoofing C Sewer Line 0 Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line Q WoodiPeOetSbm (mustbe EPA car Mad, provide make, model and
manufacturar)_
Complete all applicable Information on the application. incomplete applications will not be accepted.
Application # i n=�'QS-IGIS Dater
PrroiTCe use only
Job Site Address (mvidaW
Value of Consisuetion (labor, materials, praM
50 Lo aX-ev-
Properly owner Name Address
C0.y/State Zip
Phone
.• e�'e.1 a ffiLX4hk0,r\
S1�e 4 as
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Applicant Name Address .
city/State Zfp
Phone 4'" -
R•� able P.eof 2vie. all W- Ts;tb EM
Contractor Address
ty/Statle Zip
Phone
Contractor City of Ft. Collins Sales Tax v
Are you paying bum here ci• by repart2 � 0 Report
safe; tarmm tra Lrno+r �Yas��
Are you paying with your trust 8=unt? 'Yes
❑ No
Ls this a reddentfal or commercial project? 9 Residential Q Commercial
If residential, Is it: p single Family Detached M CondoltDwhhome (single Family attached) 0 Duplex
p Multifamily (apartment) ❑ Garage
If commercial, is It: ❑ Bank ❑ Bar 0 ChtWO 0 HotsllMotel O Medical office ❑ office 11 Retdf[
0 Restaurant O other (explain)
Is this building 5C years of age or morel E3Yes 17 No fF^ you may rte3d to C0p&ctii&ftic Amsen aEiovr
If this is for a demolition perjnit, wbatyearwas thff'bullding constini
If prior to 1973, yoy %ff need an ashrstas SIMEWMent W submit ovlbi MIS AA*ffcat 0J?
oesa iptlon Of
*ifl lawn sprinklerJbaddlow preventer, must list lioensed Plumber. If tirsi-ttme A/C, must list licensed eiet"clen. —..I !
subcontractors Uist�'raegmparlYnsmearO�yafl4CblfnrrslrcvtsaP
8ectridsn ,. Plumber
MOCnant®i Woofer R— t SSQ - - Other
I hereby atlmowiedga that I have read this application and state that the above irdbrmatlon Is complete and corrnes i agree to
Comply wlth ail requinmmts contained herein and cfty ordinances qnd state laws regulating butidtng construction. I knowtihat a
permit Is not valid until it has been paid and issued.
APPllrantr Ah ��"• ' 8 t
Print Name: 4W& �e1nK Dom
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