HomeMy WebLinkAbout5809 Stonewater Dr - Applications/Reroof - 04/23/2015From Affordable Roofing Inc 1.970.207.0289 Tue Apr 21 16:58:10 2015 MDT Page 2 of 2
Planning, Development & i ransporia;:lan
City of 281 N. College Ave P.O. Sox 580
F— 6 t Coil8ns Fort. Collins, M 80524.
Phone g70116-2740 Fa, 22= 6134
OVER-` HExCO NTER PERMIT'S ONLY
This application is to be used to apply for the following permits only (check all that apply). Q Air Condkionino
❑ Demolitiom(nterior non-structural) ❑ Electrical Alteration (notservica change) 0 Gas Lighter O Gas Log
O Heating Unit ❑Lawn Sprinkler ❑ Mobile Horne replacement ❑ Roofing ❑ Sewar Line ❑ Photo -voltaic
Q Vert taaon 0 Water Heater ❑ Water line_ ❑ Wood/Pellei Stove (must be. EPA cerdiied, provide make, model and
manufacturer)_
Complete all applicable InioirrMa(tio�n on the application.
Application = O
For orr"7te use only
Incomplete applications will not be docepteci.
Date �-1-• 23. JS
Job Site actress crequir�j
f
Vat or Coristruction (labor,. materials, protr�
1
Propeti} Owner Name !address
Gry/Ste Tp
Phone
�Y1(ll5 SWIgL
� -Q0 %Vt8,� 6b6A
g7aI&A
Appllcarit Name Address
tytState Zip
Phone q-7
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Tt; !bu �� ETC
Contra—ctor �.J ,address
-�/State _io
Phone .�
Contractor City of R. Collins Sales Tax
i�raxnumbsrisrwulredby- aycun,�zcor-.
Areyou paying with your trust account?
Yes Q No
1 is this a residential or commercial project? ,jam kesidLn5al it CommEroal
it rzsdedual, is it; J�r57ngie Family Detached O CondofLn:vnhome (single fancily attached) ❑ Duplex
I :0 Multi,�mtly (apartment) D Garage
it commercial, is it: 0 Bank ❑ Bar ❑ Church O Hotel/Motel ❑ Medical once ❑ Ounce ❑ Retail
0 Restaurant El Other (explain)
is ti is tutllding 50 years or age or morz? ❑ Yes ' ❑ No ryes, youmaynaed t0 [ontdci-Historic f/nservavon
-f this is for 2 demolition permit, what year was the bullding constructed?
t`prlor to 9io, you will need on asbesms assessmerrttc snbnit vrirh h9Ls application.
Oi
pie. fawn sprin1der/baGa7oW preventer, must list licensed plumber. Ira• first-time A/C, must Gs fire ed eleC.rlctan.
s:ubccntracYprs. UyltheComaanynameorCry OfFrCadUns11CeRMa
ode ic13n. Plumper M3d131VO Roo; -.i 5 Ocher
i hereby acknowledge gnat i have read this application and state that the above Information is complera and comet i agr }p I
amply with all requirements contained herein and city ordinances and state laws regulating building construction. r know that a ,
germlt'is not valid until it has been paid and issued.
Applicant;
rinthame: 1 rr . 1v i 4 Signature ��nj `—atir