HomeMy WebLinkAbout3500 Carlton Ave - Applications/Reroof - 09/23/2014 (10)From Affordable Roofing Inc 1.970.207.0289 Wed Sep 24 10:07:55 2014 MST Page 30 of 36
'rs€OA- Manning, Develop:tnent&-transportation
t ;r rt.:^^ 2-81 K. College Ave P.O. Box 580
Fort Catlin, CO 80524
Phone 970-41b 2740 Fa^ 22� 6I34
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Tti1s application is to be used to a4ply for the following permits only.(eheck all thatapply}. G.Air Conditioning
Q Demolition (intzricrr non-s`rucb-rral) ❑ Elecfical Alteration (notservica change) O Gas Lighter Cl Gas Log
0 Healing Unit 0 Lawn Sprinkler Cl Mobile Home replacement 1�f P,00nng 0 Sewer line ❑ Pilo- volWc
12 i/err lahon ❑ Water Heater C1 Water I lima ❑ ViloodlPag r . ( n`+LO-
manurac[urer)_
e_ S1bve ran_ be EPA.cenilied; provide make,. modal and
Complete all applicable information on theappGcation. Incomplete.applicati(5ns will not be accepted.
Application # ?) I 'y O� 1_ ZO Date
For of,ka Use only
job Site Address {requrYcdJ 3 Gar t'A F t Wle- Valu: of ConstrUCtion (labor, materiais� prorit)
-35
Go C c 11,,1a, LlqS
Property owner Name Address Gi�r/S�o�e ZIP Phone
1�11P_h�-�rm2 �y2a�or-�u �ir,v,n��t�� -lr C1`Sr50 acd Ile -D 1oo 2Q5a5
Applicant Name Acores
CrtyffJsbetz TP Phone q—re-
r�ar=arc_. ak'l Lit. i i 6 lZto f—'L'C Cc 50OS�S a7-�6o6
Con'xactor
Address dYlSrair Zip jhone
Cbnaac%or CRy of Ft. CaMns Saies i ax .� Are you paying taxes here or by cafe;repor�� Cr � r� R r
taxnumb2rv.rcquJred oyes/ mne�libra- Are. You paying wrl3, your trust account? Vyes [7 No
is thls:a residertti-a1or commerdai pro3ec�? 6 Reard I Q coriinercial
resMeri t, Is TI" �2 SngleFau lv Detached 1SLCondoltownhome (single amlly attached) 0 Dud
EX
G Muldiam0y (apc-ranent) ❑ Garage
!f commercial, is it: .Q i3ank 0 Bar ❑. Church 17 HotelJMoi -1 E3 Medical oin'ce f? Omce 0 Reta1
0 Restaurant G Other (explain)
is this building SO years of age or more? r7 Yz; �&) No iPy8, you mayn2ed to coata-ctY.iscoricpleservanon
Ifmis is or a de:nalit on oe: wit; whatyear tyres the'buildi constnic.ed�-•
� L prarzo `3T5, you �+iJ/ need'an ashestns as�srneni: io submli: �vrtli this applaaaon:
Description of
a`1f lawn sprinkler/backrla�, prevent er, must l'� licensed plumber. ii firs< me A/r, must lip licensed ele ician-
Subco��i:rat�rs:[isTfFrernmpzvyrrane.arGiyofr2lalGnslic2nse,�.
r-Jecidan Plumber tdedprur�i Roofer R= l ESQ other
1 hereby aetvnwiedge that! have read thL.application and stele that the above infnrmaifon is complete and correct. I agree bo
comply with all requirer antscontained herein and CRY ordinances and state lays regulating building mnstruGiom 1 knowtihata
permit is notvalld until it has been paid and issued. 21
Applicant: c �
!1 v�/
Print Name; 1 � +.c., SeliM.1 %lam S Sigriai�e;� .• 't'!'�<-� � "" Dal€ � /