HomeMy WebLinkAbout467 Dennison Ave - Applications/Reroof - 09/09/2014atly N. co!lev- Ave r,0,.fxz;t 580
C.
Fort Co!M
rx Win
Phone 0,70'
OVER,.-THE-COUNTER:Plz:R!Vil-T'l�-1; ohlily
yi,jis ap W, "IM (check E 11 that a I Air. CondMoning
plioation it to be!used -to apply for thz, � folio 'k I PP
J�emplftion (Interior non-structural) D Electrical Alteration (not servi change), 0 Gas Lighter 0 Gas. Log
0 Heating: Unit 0. Lawn Sprinkler prinkler 0 Mobile Home replace �90,01fing. 13 Sewer Line 13 Photo -voltaic
0 Ventilation D.Water-Heater 0 Water'Llne D:Wood/Pellet Stove (must be EPA cartifled. provide make, model and�
manufactura*
Complete all applicable information o Ahe ap Incomplete app I Ionil'be acceOW,
-plication ��I�
AppliqlaFJoInplyk
U only If
3 . its Address (requIred) V.aiue of Construction (labor, materials, profit)
Appe I rty,pwne . r Nam' e Address city/state Zip Phone
Applicant Name Address clty/$t4e Zip Phone
. C. ntraLr 11c# RA'PW- Address city/state. Zip Phone
pe- RnoLoa
ContractorCity Of R6 Collins Sal Tax # Are you Paying taxes here or by report:? [Mere El Report
We$ w nuMber b- requiled by all convaepts. Are you paying with your trust account? Se'res El No
Is this 6 residential. or 0 i�rcjal project? WZsldentW D Commercial
e
If r reSidtntlafe IS It: . 1912te Family Detached [3 Condoltownhome (single family attached) 13. Duplex
13 Multifamily (apartment) IiGa'rag6i
If comMerclai;, is it M sink 13 Bar d thurch 13 Hotel/Motel 0 Medicni office Cl Office ;'Retail
E3 Restaurant 0 Other (expla
Is this building 6P years of Age or more? MYes. 12!to' 0 yos, you may need to contact PWotfc Preservatlon
If this is for'a demolition permit, what year was the. building,constructed?
Description . of . work 12 'Sa (XAV
*If lawn sprinkl&X6cknow prevenW, mustlist licensed plumber. If first-time A/C,. roust list;l1censed electrician.
Subcontractors: L I & ffie company. name i or -Co of Ft. Collins Acense #
E10, on PWrnber. Mechanical RooferOther
-1 hereby nknoWedge.thatthave read this appliotion and state. thattheiabove informationis complete and correct I agree to
complyWth all requirements contained herein and, city orc .. lirmnces . and s. . tiftlaws regulating bu I . Vi n g, contfitic8onl, I knoWthat a
pert"i0s n0tvalld until Ithas been paid and issued.