HomeMy WebLinkAbout801 E Drake Rd - Applications/Reroof - 03/10/2015 (3)From Affordable Roofing Inc 1.970.207.0289 Tue Mar 10 14:45:04 2015 MDT Page 8 of 20
Planning, Development &Transportation
r� �;. r� 281 N. College Ave P.O. Box 58C
,,�--6LT'e Co���11 s FwT Collins, CC 80524
Phone 970-416-2-740 Fax 224-613=
OVER -THE." aCC` 0U TEI PER M 111"US 0NL.V
This application is to be used to apply for the following permits only (check all that apply). ❑ Air Conditioning
G Dsmolition (inferior non-structural) ❑ Electrical Alteration (not service change) 0 Gas lighter 0 Gas Loa
u HesZna unit 0 Lawn Sprinkler El Mobile Home replac®mant G Roofing O Sewer Line 0 Photo -voltaic
U L'aniii3iion t 1 lAratsr Ha2tar ❑ LNaier U.-le 0 4V00d/Pellet Stove (must be EPA certified, provide m2ke, model rand
manufacturer;.
COmDieie all applic
able information on the applicatlon. InCompiete applications Will not be accepted.
M...iplircation -_-r00 J b � U a Date
Post oPlicz use Dory `- --
! yob Site Address (required) iue of Construction (labor, materials, pro i[)
i
-� -kteal G
?racer r O'lsner i�ame iddr City/State zip Phone
t'Ylnptn�lnlort�c�`��n # tC>>]�pllil+lS R�Yi�4, �n 2 _ czar 7
Aopiicanu 1y3n1e Address l City/State zip Phone
iTc'C�r-Ci 1LUC1 t-i'r�n, o7-i1 U. f� �CJ • 1L �=s'yL�v�"{i�.71(
nt ofor
Address 4-y/s
lAtate 7
_l7 PilOih@
Ccn-rrctor City of Ft. Collins Sales fax
So'es trx rumD;ris rc-gW n Dq aff tantrado s
Are you paying with your `rust account? yes ❑ NO
is this a residential or commercial -pro ecL?
r . J Residential L% Ccrrmercial I
is r fGendal, fs f£: -IR-Single Family Detached 0 Condo/townhoma (single family attached) ❑ Duplex
i ❑ Mul i€amity (apartme-nt) ❑ Garage
commercial. isit: 0 8anl p Sar El Church G Hotel/Motel 0 Medical prices ❑ CFce Q Retail
13 Restaurant ❑ Other (explain) }
i is this uuliding 50 years o; age or more? q Yes ❑ ii% T' yes, you ma;(nead rn contact N,/sfpric Frzsaruaaon If this fs fur a drernolieion perrlit, what. year arras the building constructed? ?
if prinr is Z 97. , }roc w& need an asbestos a55e5s(nenC to ffiIDmi[ with This application. i
i
Des,zripdon of work Y o a rr . '
^I; izvrn sprinwWbacktiow preventer, must fist lfcenseo olumber. If first-time A/C, must iist I1cerL5sd electrician.
i 5ubcontnctom!JJgLLvrecomeanynamecv-CjyofFiCuN1i7s11cense=
i ri=_ rict3rL plumber
mec;mr.icat
.vl..._ Other
? heteb, awowiedge that! have read Geis application and state that the above information is complete and correct. i agree to
COiriply toitn all requirements contained herein and city ordinances and slate laws regulating building construction. _ know that a j 1 Gerrit s not valid until it has been paid and issued.
-'ppliesnt. - �—
s=rint rdame: ri �t t� o�'Jt�g Signature _ `rh