HomeMy WebLinkAbout2914 Cornerstone Ln - Applications/Reroof - 03/23/2015From Affordable Roofing Inc 1.970.207.0289 Mon Mar 23 09:38:29 2015 MDT Page 2 of 2
vj ty of Planning, Deveioprnenr & Transporta*iar,
Fort
281. N. College Ave P.0, Box 58L:
c� a � -ort Collizc, CO 8D52
Phone 970-416-2750 Fax ?24 513=
OVER-THI M-COUNITER PER6T01TS OINILY
This application is to be used to apply for the following permits only (check all that apply), 0 qir Conditioning
0 Demolition (interior non-structural) 0 Electrical Alteration (not service Change) -1 Gas Liaht0 i7 Gas Lc,2 u t aiing Unit ❑ L awn Sprinkler 0 Mcbile Home replacamari 0 Roofin ❑Sewer Line Qj 7a•A g O photo-vol!aic Vent le5on C} Vi c.,r Heater ❑ V•/_for Line 0 l'VOadfPeliet Stcve ms -" d
-manufacturer;. ( '�� b2 EPA Car=un2d, orovids make-, mods] anri
l +t�m )l�Ct all e}1r�llCdblG filidrm3tign on the application. Incomplete aPPlications will not be accepted.
paki�a or _--- PJ �� I �bcl � Dace
vretfico use only �---- -- -----_
sob `site Address (20uir�d.1 � Valve of Construction � --
r coon {labor, materials, prgdt)
! "rropert'y Owner (dame -� --- ---_-• _
^ Adds City/state Zip Ph
one
irk' ttiCs C-
!I ant Name \' ..lj'�
` Address Ci ,'Slat= " L12
t ETC
r-� Zip Phone
. car-i^��i_nvj^ O �- 0; 1 I W. l �..-TCi i
? Address r
Phone
anintractor Cis/ o` Ft. Collins Sales Tax y
! c_;�-,;;i nun6?r:s r�tur�d by z(.' conira+:ton.
Are you paying with your trust account?Yes tfo
is this a ra�;ide'%Val or commercial pro -a? 1 CgmmeruaE
ri l =-`N .a . - .., k .�ReSidenba
danjal, i_ n. -a-Single Family Detached' ❑ Condo/toivnhome (single family attached) 0 Duplex 0 Multifamily (apartment) !D uarage ;
i` co•'nMerciai, is it: 0- Sank 0 gar 0 Church ❑ Hotel/Motet 0 Medical of �,j ce 0 orrice G >7etaiE 1
11 Restaurant 0 Other (explain)
i Ta ;his building S0 veers oc age or more? 0 Yes 0 f��g If yes, you maynEed b mntaCtNforfcstPreSBrt�?ion
•' If _pis is for a cemolitiort permit, What Xmas the building constructed?
r i,mor iU 1975 you tvll/ need an asbweaD a-,* essM 'nf to subf i V.Vth <his aCOlfeaGOn. �--
Descrip on of work - 7� -�
�' J Z j)±,... CIF i
•' - ,
i ---J lCrciil C'i_tY t�->1`ll '•
e r+^ >prinkteryba is low Grey_=rite,, mud list licensed nlumbcr, if first -tune A/C, must Mgt licensed EIeLTICIan. J j
Subcontractors: 1 ,Y a comaan}• na.�e w Ciro of FC Collins license+
t
.>.IEct'iClen-------- vlurnber Mechanical
e iiei'c y acivu vriedge sat % have read this application and state that the above Information is complete and correct, 1 agree to
ci m?fY iv�h ati r ecluke rents contained hereln and city ordinances and state taws regulating building construction. _r know that'a !
'Cr-mit is riot' valid until it has been paid znd issued.
Acpiicant:
Printyame:_ i_signature % /�!! :. :.•-^ ! C`:'