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HomeMy WebLinkAbout4517 Seaway Cir - Applications/Reroof - 10/13/201410-13-'14 10:36 FROM -Premier Roofing 9704848308 T-239 P0006/0007 F-485 art Collinsow rrannusy, No .... r....... --.. r . 281 N. CollegeAve ....6 Fort Collins, tb 8094 Phone 97(1.416-2740 Pax 224.6134 OVER-THE-COUNTER PERMITS ONLY This application is to be used to applyfor the following permits only (checkall thatapply). 0 AlrConditioning 0 Demolition (interior no"tructurai) 0 Electrical Alteration (not service change) 13 Gas Whiter D Gas Log 0 Heating Unit 13 Lawn Sprinkler 0 Mobile Home replacement 17 Rooting CI Sewer Lhe V Photo-voltalc t✓Bd 0 Ventilation 13 Water Heater 0 Water Line G Wood/Pellet Glove (must be EPA ceK, Provide make, model and manufacturer). Complete all applicable information on the application. incomplete applicetionswil not be accepted. Application #_— fioro/Ace use onry Job Site Address (requlre,i) Date Value of Consttuctica (labor, materials, profit) Prc arty owner Nam Address Gty/State Zip Phone '10 An . IQ term;?_� Applicant Name City/State Tap Phone kmvRX)Qnq tractorAddress Cl /State lip Phone 480 VL93, Contractor City of Pt. CoWN Sales Tax # .s�leslaxnumberlxre7ndad byellavrlydarma Am you paying taxes here or byreport? EMreere 13Report Are you paying with your trust account? CI Yes 13 No Is this a residential or cadty erciai project? 191residential ClCommercial S residentlal, la it: Single Family Detached © Condo/townhome (single family alladed) 0 0uplex 0 Multifamily (apartment) 0 Garage If commercial, Is It: G Bank 0 Bar CI Church 0 Hotel/Motel 0 Medical office 0 Omce 0 Retail 0( 13 Restaurant 13 Other (explaln). is this building 60 years of age Or more? LI Yea o lfyes, you maYneedio wntaar//IsMs'cPnnaHon If this Is for a demolition permit, what year was the building constructed? tfpdorfo197S, YOU w/Il,10danasD@af Agassnrentd0aabm/t80thlsagolisadam. V lawn spnnider/badcflow preventer, must net licensed plumber. if first time AJC, must Ibt kunaed etearidan. I U b 00 n I ra doyr, LW go LVJV5,7Y,13fi700,"0W Of ft CAft lkb= of MschantaaL _ Romer Other IeRdciak.�,_ Plumber - hereby admowledge that I have read this epPlication and state that the above "Irma non is complae 11111 tuned. I agree to omply with all requirements contained hen4n and city ordinances and state laws regulaft butdirg construction. I know thata iermit is not valid until It has been paid and issued. opliN ma: aG signature Date d�