HomeMy WebLinkAbout743 Marigold Ln - Applications/Reroof - 09/09/2014Sep. 9, 2014 11:42AM ADVANCED ROOFING No,1691 P. 1
City of Piatiningr Development & Tl ansportation
` 281 N. College Ave P,c', Box 5s0
9 &t Coltin.�J.. Fort Collins,- CO 80524
Phone S70-4I5-2740 Fax L4-Bi34
OVER, -THE -COUNTER PERMITS ONLY
This application is tone used to apply for the following permits only check zll that apply). u ^
( Air �,ond� toning
Oemotltlon (ifterlOr non-structure,l) D _ic^CZrical Alteration (riot service c1hance) D G--,as Lighter �03 Gas Log
Q Heating Unit 0 Lawn Sprinkler U Mobile Horne r epiacemen 7 Rooting 5BWer Line !! 1 Photo.yoltalc
0 ventilation 0 Wafer ;Heater n Water Line r l! NOOd/ ellet Stove (r,-rust be EPA certified, Provide make; model and
manLiacturer).
i
Complete all applicable information on the appllcat9Cn. Incornplets applications will not De accaptedi
Application T_.81g0 8gN14 Date
For offics use only
Property Owner Name Address
(2 4cdrs
I N)i. v
Cont-actor Lie # Address
Cone actor City of R� Collins Sales Tax n
seles �xnumber is requireebyaff conty=rs
aaoslO
" r
value 4i 5.vna. union (!cctcr, material.-, 2roflt1
/
LiP
p
Are you pay ng'ta;es here or by , e—port?
Are you paying with your trust account.?
Phone 9 2e)
Phone 04�0
Phone
Here 0 Repo
p Yes Q No .
Is this a ,esidentlal or commercial projec-t? Resldential Q Conimerdal
?f, residential, is it - Single tamlly Detached•• ' 0,CbffcWtownhorii-a' Duplex• _
11 Multiramiiy (apartment) Q Garage
If connerdai, is -it" iL. ❑ Bank it Bar Q Chute art Q Notci/i~fct=1 Q Media! cr ice ❑ Cr;ce Cj (L= aii
Q (explain)
is tits:luilding 50 years of age or mere? r Yes G No If yes, you naynee_H-to cGnicC HIs2Dr1C pr ac8r✓ot%on
If t,`iis s For a demoliuoh permit, what year was the building corrstruced?
I'pr•'or ca 1975, you will need an asbestr—c assessme,?e to sub .nit with ! r/s app/lcztorl
of wor',C
`i
*If lawn-sPrinkE,/bac;71ow preventer, riws, iist licensed plumber. IF first-time A/C, rnust lu-, iice;`sed elf :'an•.
Subcnnuafters; (Lc, Lie com)9anynerecrCity ofAiCollinslic`nse "
e�-iozn P!urbE� ME:`anical " •"� / � ,
om" er
1 nere'Jy EM'Icwle'90-d mat I have re -ad this aPPRc dOn and State that tine above inf orinati0n IS cOmpiefe •and cor2c`., 12grCv'
cot ply wi�h,ali reGuir`irierts canyired iizreto
irn and city ordinances and stPte laws r 5ula;;ng building mncuucton. I know that a
permit is not valid unSi it has been paid and issue,•
Print Name:
� �[�,}•` Signatura
..� .Data
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