HomeMy WebLinkAbout5201 Mail Creek Ln - Applications/Reroof - 09/05/2014 (2)Sep. 5. 2014 1:43PM ADVANCED ROOFING
No.1673 P. 2
City. of Pia7ningr Development & Transportation
p Ill N. Collega Ave p,C , Sox 580
F6rt Collins... FortCOul,s, Co 8052e,
�-Phone 570-410-2740 Fax 224-8 3=
OVER-THE-COUNTER PERMITS ONLY Iq , 0-7
This apolicatior, is to be used to apply for the `ollowing per,l,i?, only (check ail that apply), CI Air Conditioning
rr Demoifilon (inter(or •non•stnlct cal) �� Pled ricai. iteration (not service change) O Gas i ighter G Gas Log
G Heating Unit n I awn Sprinkler i] Mobile Home molacament Roofing a Sewer Lire ❑ Photo -voltaic
G Ver>tiiation G Water Heater 1 Water Line 0 Woodrpalle: Stove (must be EPA, certified, provide make, model and
mariulacturer),
Ccmpiete all applicabie inform tion on the application, IncoMpieta applications will not as accep ad.
Apoiicazon Tj04®Q �,5 Dal.= 9^"fr1/
For Pi use only
;e= Sae 4ddrese
f �C��r�..Y Gs Cu. won (tabor, mz-�r'2fs, pro
fiC)
is u lis a residential or commercial prole✓ ? )(R�sidendal m Commerdai
It n=idential; is it. 'Single -Family 0e?ched`• t7 Cbndo/toWnfibni 9(_ang.-1• e .
`ar;,il'y atached) Duplex �,f_ •�
❑ -M ultr
amiiy (apartment) M. Garage
If commerdal, is -it: ❑ Sank ❑ Bar ❑ Church U•• Hotal/Motel M Me~ical ofce ❑'G ca CI Ra�oil
❑ Resaurao❑ t oter (explain)
Xs building so years of .age or more? u Yes 0 No ,Ifyps, you rnayneed to canted: ri6601lic presefil2 on
If this is for a demolitioii permit, what year was the building constructed?
Ile pro✓ to 1975, you will need an zsbestas ass�riEnt to submit wr9 65is spplirah'on,
of wori
!f lawn spr n ,er/bacic o preventer, must Iist licenser plumber, if fist ame A/C, must lis licensed efectlician.
subcontractors; /is thecompenyr=necrGr/orr?Co/rnsrcens2,�
ectr4RO Plumber Mecc anlcai
Rcefa
Other .
P hereby acknowledoe that I ,have read Ni applicacden and state dtat the above Information is complete and corccLL ? agree
comply wia5•all reguira,�ent3 contained herein and dtl oreirances and -Rate laws regulating building c;nsuuccior, I know that a
permit is not valid until it has been paid and issued,
Applicant;
Print Name; ' signet ir=
Data