HomeMy WebLinkAbout733 Langdale Dr - Applications/Reroof - 05/13/2015From Affordable Roofing Inc 1.970.207.0289 Wed May 13 11:33:31 2015 MDT Page 2 of 2
Planning, Uevelopmetnf & Ft2nsparca woe
�; �v ra# ' iVe AveP.O. Bu 580
;tom 2$_ N. Co.l vA P.
A li r %Cdhans For. Collins, CO 802"1
Phony 970••416-2740 Fax 2 ,-513c
This application is to be used to apply for the following permits only (check all That apply). a AirCondiiionino
❑ Oemoiibon (interior non-structural) 0 Electrical Altareaon (nor service change) Q Gas Lighter 0 Gas Loa
0 !Jeatino Unii: n Lawn Sprinkler 0 Mobile :tome replacement G Root'tnn 0 Sewer Ling C1 Photo-voltuiC
r Vantiladon Cl Vir tnr Heater CI IN_ier Line n VVoodrEslLt .Stove (must be EPA c=_rufleo; provide make, tnodai snd
manufactutwa ,_
Gomplete all aRRlJ¢abl iritOrrnaJon an i e app ication- Incomplete applications vrill not ba accepted.
Date
ld?'Ofieueonly r —
eb Sste Address crepumff)
erc1' Owner
"-'. i4 cant Name
rCr' oar
cont m.;:or City or Ft. Collins Sales Tax
S?c �:r rurr<ST U fc�lrp� tj}' c'y ct71tir2Ccvr.:.
atuue of C nstmctlon (labor, materials, pront)
Add».ss city: S a to Zip ^Y Yho K
__50,Ly1 _ inlurv,- rn 1Q`, i -7'3rtit 22_.ii
Address Ciy1,5lam Zip phone q-70
Address
ZY
Are You o8ying WICK your irust account? Y
-
Phone
s r. •ts a r= ide filial or mr-unerclal wcr a. ? Rasidential U commercial
Us aendal, :SitSingle Pamily Detached ❑ Condoy'townhome (single family attached) 0 Duplex
Multift'mily f parbrnent) `-1 Garage
Y �J„-M r-
l:]ier[lil, isli: II San: Sar (i CnurCi. ✓] to7JJMo �{ Q MCdicai OR, 0 Ortice G Retail
t Re5taurani- ❑ OiTler (Explain)
is ibis : ullding Be years of age or mot? 0 Yes ❑ No �.= s - --
1`E . Yvu naynead ev crirttacz HIs[oricPteservaffnn
tn? it ;-ir a demolition per.'nit, lami year,p.as the building constructed?
&-n _ 725 yav iv suar tic v4rh Lftis anNfcarinn.
Q No
DescrIpt
-ton Chi VUOriC �o p,� ---
o - f�� e s� Ir n ii
n . - . .. _ _- C, r=rJc�_ . ;! tR_.3 / i i! S
"fir ievin sprinkterybacl low preventar, must tt;;. licensBU uluinber. it 6n,z -time „yc muss IiSi it used a iecirlaan-
:7:r2G:6.S: US'iT?CAOtQ3nfr/l2ri(: fN'(�iP/OJ'14 t.0�ll.7S lICEgSc
==' Other
�ILdIP.t
z r y i orreGge fnei i have react this appticadOn aand state that khe above infotma3on is complete and correct. I agr--e:0
:,�n�pi;' ;;'itit all regal sr„e»a carueined herein and city ordinances and state laws regulating building Construct)on. I know that a
;fie (Tilt?$ riot vMld Until it has been paid and issued.
r; nr:Signature.
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