HomeMy WebLinkAbout5233 Boardwalk Dr - Applications/Reroof - 12/15/2014From Affordable Roofing Inc 1.970.207.0289 Mon Dec 8 08:23:42 2014 MST Page 2 of 2
Fd�"®City of planning, Development & Transportation
���➢� 281 N..College Ave P.O. Sox S80
i U N Fprt Collins, CO B0524
Phone 970-416-274() Fax 224-6i3g
WUrNTER PERMITS
This, application is to be used to apply for the following permits only (check.all that apply). ❑ Air Conditioning
❑ Demolition.(interior non-structural) I7 Electrical Alteration (not se lot! change) 0. Gas Lighter O Gas tog
❑ Haating unit ❑ Lawn Sprinkler t3 Mobile Home replacement ❑ Rooting. 0 SewerLns G Photo -voltaic
❑ Ventilation ❑ Water'Heater Water Line ❑ 1Npodlpe let Stave (must be EPA certified, provide make, model and
matrufacturer),
Complete all applicable information an the application, incomplete applications Will not be accepted,.
Application 1:�A2014A Date
fi7r 0MCE use only
30b Site Address (regtrfred) Value o Co ,ion (a nr, materials
5a33 &nrdt�,nt K Dr R�(T C, %� j S profit)
Prroperty Owner Name .Address City/State
UllAYY`71(i0 S�n,MF1.J rYl n..n.;n...n.. ._ leer r..�. 21p phone
��FPI!LU11L rvame Address City/state Zip -- Phone � 7)
fJ
�elrl�e 12ao�, alp lw -7 1 rTC �t>��5 aa��
Conlvaeor Address, YrState
ZrP Phone
Con trctor City of Ft Collins Sales lax
.�/?s'.taYnumb`ris rz�aired bYBB mnlla[:or'
Are you paying with your trust account? Yes ❑ No
Is tHis•a residential or commercial proJEW -"Residential ❑ Commer,
if residential, is it: -W' Ingle Family Detadred El Cando/townhome (single family attached) ❑ Duplex
C7 MUInParmly (apartment) ❑ Garage
if commerciol, Is it: p Bank Q Bar Q Church Q How/Motel ❑ Medical orrice 0 Office q Retail
❑ Restaurant ❑ Other (explain) _.
Is reels building 50 gears oi. age or more? 17 Yes ❑ ho Ifyes,. you rrrayl?eLd to cnntactR1SXr/cP1aaawbon ffixYor hi d9T�. ypu ydJt s is fdr a demvWj n permit, wnat:ysar vrds the building constructed7
irAneed an asbestos assesarnent to submitW M this app/rmtloia
of, work
(awns mkler !x lbdckRoW pteventer, must list licensed (lbnnber. If tors;-Jme A/C, must list licensed aleu7iQan.
Subcontractors: UsiUre [ompanynameor Gty.ofF2Co)fins//Ce2se '
Elec^:id-n Plumber Machanip
L_ RDPF2r -- 1 5 Other
i hereby acknowledge di ati have read sets application. and state that the above Information is complete and cur, I
gdmdly With all. requirements Gontatned herein and city ordinances and state laws regulating building constr agree a " Permit is not Valid until (t has been paid and issued g g uCbdn. I t a
Applitant:
Mot Nami