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HomeMy WebLinkAbout3219 Nelson Ln - Applications/Reroof - 09/09/2014FROM :kessler FAX NO. : Sep.09 2014 09:18AM P2 Qty.of GO�iil'1S Planning, Development & Transportation 201 N. College Ave P.Q. Box 580 Fort Collins, CO 80524 Prone 970-416-2740 Fax 224-6134 OVER-THE-COUNTER PERMITS ONLY This application is to be used to apply for the following permits only (check all that apply). ❑ Air Conditioning ❑ Demolition (interior non-structuraQ O Electrical Alteration (not service change) ❑ Gas Lighter 13 Gas Log ❑ Heating Unit O Lawn Sprinkler ❑ Mobile Home replacement JXRooflng 13 Sewer Line 0 Photo -voltaic * ventilation ❑ Water Heater 0 Water Line 0 Wood/Pallet Stove (must be EPA certified, provide make, model and manufacturer). Complete all applicable information on the application. Incomplete applicatlons will not•be accepted. Appl'lcauon # Date For offlw use only jr Job Silo Address (required) Value of Construction pabor, materials, proltt) 3Z1q Nclsorl Inn 1 �0 Properly Owner Name Address f3ty/State zip Phone :E& Ke'ahn • 21c1 NeASm-16 M, Co 865Z6 223- I-) Applicant Name Address C1tY/State Zip Phone Contractor &xesle r Address we. (018 City/slate Vi ca-or•?9z cf r, Yip CWjD,) Phone mac. BATAS-40-68 S6 Contractor City of IL Collins Safes Tax # t3 S&WftrMx9W1S18qt&Vdbyaffmnbaace+M Are you paying with y*urtruSta=unt?)<Yes 13 No Is this a residential or commercial pro)ect? ,WResldentlW 13 Commercial If residential, is It: Single Famliy Detached ❑ C=Wtownhome (single family attached) • . C3 Duplex la Multifamily (apartment) 13 Garage If commerdal, Is it. © Bank D Bar 13 Church ❑ Hotel/Motel © Medical office © office 0 Retail ❑ Restaurant © Other (explain) Is this bullding 50 years of age or more? CI Yes 13No if jw yew mayne!ed to enntgd HL;kWc PnewvMon If this is for a demolition permit, what year was the building constructed? Yprlor to 1975, you wpl need an ash aSmWnent to stubm/t arch d&app,Gs=at ton. Description of work *If lawn sprinld&ftiaddiow preventer, must list licensed plumber. U first-time A/C, must list licensed electrician. Subounractors: Ust doe mmpany name or 01Y ofFt t27Hns /kerrse 0 aectecian Plumber Mededcal Roofer outer I hereby aclmov4edge that I have read this application and slate that the above IMnnnation Is complete and corral I agree to comply with all requirements contained herein and city ordinances and state laws regulating building construction. Y know that a per" is not valid until it has been paid and lsogsd. Appllcarft Print aN