HomeMy WebLinkAbout1478 Front Nine Dr - Applications/Reroof - 11/10/2014From Affordable Roofing Inc 1.970.207.0289 Thu Oct 16 19:19:53 2014 MST Page 2 of 2
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Planning, Development 4 Transpodabon
291 U. College Ave P.O. Sax SK
Fort Cbllini_, CO 80524
Phone970-416-27,40 FaX224-613e.
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OVER-THE-COUNTER PERMITS ONLY
This application is to be used to apply for the following permlts only (check. all that Apply). O.Air Conditioning
ling
0 Dernojj'sibu (interior non-structural) O.Electricul Alteration -(no, servica change) E! G'aa Ughtev 0 Gas Log
0 Hearing Unit 1 Lawn Sprinkler 0 1"WiDbile Hprne reptacemerA MRoofing 0 Szwerl-tns 0 Photo-voftai-c
.0 Vs-04flo!) U 1,14aier Heater 0 Water Line 0-WoodiPellai5iove (nnvstba EPA ceAififie�d. �-royide mane, rilo,161.an.o
l' A3 mil)ltte all BPOCab[a in.formalibn on the application: Incompt6te a0PjICatjojjS will not be.accepted.
,App . li,caij.0,1 # '61HI (� I Date 0-1 4
=bf-ofi'ice Use - eery
10h Site Address (req&fiea)
Prof,%,erw Owner il.amp,
Acidra5jr
Name Address
C I mItractir -) gddress
C111,1-tructor City of Ft. CoMas Saiei$ TaXiEt
Value of Construction (tabor, materials, prjjr)
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City/state:
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Qy,/Staie Zip Ph Cin 6 q (ji
241 F- h o r:,---
AreyoL: paying with your trust ;-,ccourit? Yes 0 No
canitnerlcia; pnpiacK2 �. Residartti&, 0 Comrwjwol
r= Idar-, 1, -ingla Family DetyiUieJ 0 Cbnd-ojtc4#%mhqme i
-5 �-�a 5 Dup e>,.
Mdtifamqy (aparrrnant) 0 carag a
if*wmrrlerciai, isit" El Bank, C3 Bad C] CNirch CJ 1-rb(elf�4otel 0 iviedtal oralce Ef (jfTjc-- El petall
0 ne3taU,-Ee
..It El wl& (explain)
�5117is bLiltding S 0 -ears of age: rr mrM' P YeS D NO IT.Ve.F, PW, 47,OY reed 40 4vnfoct H&i r Ph2wrmffba
K-".; a d2M:o1..i0on iiernit,- What year,,*Ams tkit budding const, ucted?
-v supmk �vith 61L; V-Wh;�706Z)n yod MY i-wolfafi ag-q��snme-nt
OCS-Crilpan of work �C,:l'y a Q
lawn 1'Censed plumber. IF Fr>'Afte At(--, mUs� electrician-
5z4brmntraCoors: Uir We c=Ptlrvnam,- Or oty OfFr
Mechwa=L_...._._ . RwLn, JL=1 Other
i hor4e% reaid this andstetc- that ithe 2biwe into oration cL, plete L PE, t—S and Dr-,.CL M qr% �O
0'.iAIY I-Ifith All and city n arid 57-;are jaws seguli3ting bujjdhq Lajsb,-�djon, r 12W. ata ordi antes kn th
Uern-1 L� is qQt valid antil it has been paid and Issued.
2
M at Name, ) r r, .i 2 signature