HomeMy WebLinkAbout406 Cormorant Ct - Applications/Reroof - 10/06/2014Planning? IDevelopnreI Tiarsponatic ,
Ci jy o$ 281 N. College Ave P.O. &A 580
VVViii ���.
�� �I� ins, 05 Fort CollCo 24
phone gns, 0 -274Fax 224-6134
OVER-TH&COUNTER PERMITS ONLY
This application is to be used to apply for the following pamits only (chock all that apply). 0 Air Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Moblie Home replacement ❑ Roofing E] Sewer Una 13 Photo-vofialc
p ventilation p WaterMeater C Water Une 0 Wood/Pellet Stove (must be EPA eartffied, provide make, model and
manufacturer).
Complete all applicable Information an.the application. Incomplete applicatioim will not;be accepted.
Application RCI Date .
�nr. rme only
lob Site /ld*m lraqu/red) Value of Construction (labor, mate:t % Pmflt)
� (tv-, $
property Owner Name Address �p Phone
n�tty/slate — _
# Q-! Addrm W/Stabe Zip Phone
C.otttra3�or City of Fit Collins Sales lax #
tsar � � raquFadbY ad aarx
Are you.paying lazes here or by report?,Here ❑ Report
Are you paying w b your trust account? O*es • ❑ No
Is this a residential or 1 Project? ❑ Commerdal
If , Is It Stngte Family beta 0 Condo/townhome (single famgy attached) ® Duplex
p (apartirnernt) 0 Garage
If comff dal, Is it C] Bank C] Bar C] Church C) HoW/Motet 0 Medical office 17 Office 0 Retail
C]Restaurant (e) needtoonloaHtsiwkPrewvadw
Is title fwllding.50 ysan ol't� or nmre? e? Dyes Irye� yw �'
if this Is for a demoiltion perrak what year was the bulldtnp constructed?
hrpnforto 1975, yew WNrAWdan ad esos azem7wt to au&I wit/► theap lrmtlax
*� {awnspdnkWrlbaddbw preverI mist M llcused Plumber. If first-time AIC, must list licensed electrtdan.
SubconftcWwL1stftcnmpWnameorQtyofftColl1wl 0
t3e�tdan — tH�,a"tat_ R0°� Other.
that I have read this app4cedon and state that the above infematlon is complete and Correct. I agree to
I hereby eontdrreden hend try and state hays rmoaft bdding. mr5trti I i bar that a
pOrlrptyyl�'1 ellMUMn"
peraeb is notv&Bd nag It has bey pdd aml bwo KL