HomeMy WebLinkAbout1129 W Oak St - Applications/Reroof - 12/17/2014FROM :kessler FAX NO. :
Dec.17 2014 11:04AM P1
C-vty of
t'"t Collins
Planning, Developmelm iA I raltePormaon
281 N. College Ave P.O. Box SW
Fart Collins, 00 80574
Phone 970-416-2740 Fax 224.6134
OVER-THE-COUNTER PERMITS ONLY
Thle appilaaoon Is to be used to apply for the fotiovAng permits only (check all that apply). 0 Air Conditioning
0 Demonon (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter Ia Gas Log
17 Heating Unit ❑ Lawn Sprinkler 0 Mobile Home replacement XRooting ❑ Sewer Una O Photo -voltaic
C1 Ventilation 0 Water Heater 0 Water Line 0 WoodfPellct Stove (must be EPA coMed, provide make, model and
manufacturer).
Complete all applicable Information on the applecatkon. Incomplete application will not be aecepwd.
Application # b I g I ai q 2 Date
Foroflite run only
lob Site Addreas (a*Wivd)
value of Construcdon pabor, materials, per)
-417OVO "p /'7 &
//2-9 w, O sly
Property owner Name Address aty/ftft
L oui5 rye' f ra.� //Z 9 W Oe*ks� . Lye do
ZiP . Phone
AV.2/ 2F-7 - VSBZ-
Applicant Name Address
CITY/Stafo
Zip Phone
Contractor Address
it �r a Free, 62.9
aw/State
VtIz vr'l'47-dr,
Zip s Phone
Prr- 80rA "f4-7-68StI
Conbador City of FL Coigns Sales Tax # 715 O�3
Are you paying with your W.Staacount?XYes 13 No
&tWftxnr rrsregrrkedeyefairr,adox
Is this a residential or commerdal pro)ed? IlReSidentlal 13 Commeidel
If residential, is it DtSingle Family Detached D CAnd Wwiihome (Single family a=died) . D Duplex
D Multifamily (apartinent) O Garage
If eommerdal, is It 13 Bank 0 Bar 0 Cinch G Hotel/MoW 0 INc9cal dfim 0 Office ❑ Rawl
❑ Restaurant O Other (explain)
Is this (wilding so years of age or morel 0,Yes 0 No if yw, yrw nwneed to wntu t Historic vr+?servaObn
Ir this is for a demonthm pennit, whet year was the bulldit crostructed?
Ifp*rm1975,You wallneed ana a090M Cfa5 Udm/tidl&difs40affm
preverder, m�lid Wmnsed plumber. If first t rtre A/C, must tilt Ik wind ele*dan.
Sabeontaetors: List On campanyname OrOyOfRCON Aoenea 0
Flw b f Reofer^ Other
Qem'idan,. --
I hereby e*nmdedge that I have read thls appdcetfonaAd state d atthe above infim ation Is conViete and correct I agree to
withnot u Itpeed and hwed. and state lareregulating; building awrshudbn. I know that a
penuft In
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Pant Nam