HomeMy WebLinkAbout3909 Glacier Ct - Applications/Reroof - 10/16/2014NOV-1122-2014 15:55 From:advancedexteriars
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Fort Coll
Phone 9;
OVER.THE`CpUNTER P�
ihis application Is to
❑ Demolition (inferior non structural apUsed t*ply for the followin
4 Heating Unit p ❑Electrical Alteration permits only I
0 Ventilation ❑ yy wn Sprinkler ❑Mobile Home replacement
Ig
mama ater Heater ❑ Water Line ❑ Wood/PeAet Stove RooB
t:klrer).
Complete all ePplieable inform2tion on the a (must
Appi►Cadon # 1�¢ I I pplication. Incomplete ap
�` �i all ram on/y Date
]ob Site Addran (rW ,ad)
3a 04a n l _
Owner Name
I^\ I I
I APPiicant Name
Contractor
Address
Address
UC 2l Ad ressd
.r
Contractor Clty of Ft. Calling Sales Tax # Sa/ectaxrrurrrAarrsMW&Vbyavmg&.- ..
,
Value ofi
$ fr
City/State
City/state
Are you paying
Are you paying
Is this a residential or comma�al pros . Residential If residential, is it: ngle Family Detached 13 Commercial
E3 M ngleml D Co^do/townhome (single
If mmmwcw, is fi p Bank �( (apartment) D Garage .
13 Durant j3 Ctlurch 4 Hotel/Motel p
Is this buildingOther (explain) Medical
If this is foe won Of �o or more? q Yes q No If
t7er0dt, what year was the building ocnsYou ed? ne
Ifpr/orrol975,youwillneedan n9 strutted?
asbestos a ssnrent to submi wlGh ehls avn'in/ir
Description of work
*If lawn spriniderttecknow preventer, must list
List the commny name or pty of Ft Collins /�� 0-dme A/C,
Plumber Methanical�`
hWeby adtrtOwiedge that I have read this application and state that the above ive ii
ply w'dh all requirements contained herein and o
rmit Is not valid urrtll it has been dtY rdinances and state taws
Paid and issued.
ink
Name:
` Signature
To:19702246134 Page:617
Development 8k Transportation
'-ge Ave P.O. Box 580
CO OOS24
Fax 224-6134
MITTS ONLY
Wk all that apply, ❑Air Conditioning
90) D Gas Lighter [3 Gas Log
C1 sewer Line d Photo -voltaic
EPA oertiilled, provide make,
ake model
andl
Itions will not by accepted.
0/ / ( I ,ct
Mw=tion (labor, materials'
® , p cdt)
�oll:,nS Zip `so 7�j Phone(ald)
zip Phone
Zip W2Z-1 Phan 7Z0 -11
a or by report? M Nero ❑Report
trust aMount? ❑ Yes 111 No
attached) ❑ Duplex
Office ❑ Retail
lv combo H/ston'c p,aservatlon
list licensed
% Tp\ other
is complete and correct, I agree
building construction. I know that a