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Home My WebLink About5220 Boardwalk Dr - Applications/Reroof - 05/26/2015 (2)�Cky of p Planning, DevieJopment & Tmrisportati;on ',.` 6rt ��(l1�� I For N. Coiled Ave P.O. Box 580 V1� ��• � Fort Collins, CO ;80524 Phone 970, 416.2740 Fax 224-6134 OVER-THE-COUNTER PERmrTS ONLY This application is to be used to apply for the following permits only (check all that apply). ❑ Air Conditioning ❑ Dernoliffon (interior non-structural) O Electrical Alteration (not servi change) © Gas Lighter ❑ Gas Log ❑ Heating Unit d Lawn Sprinkler ❑ Mobile Home replacement ofing 0 Sewer Line . p Photo -voltaic m Ventilation L7 Water Heater l3 Water Line d WoodlPeffet Stove (must be EPA certified, provide make, model and manufacturer). ComPlete ail appllCabis information on the application. Incomplete appiicat ilons will not ba accepted. Application # Date V20-�� For afte use onty ]ob Site Address (Mquln Value of Conslruction (labor, materials, profit) 2 V �dr �3ld B 99.z . Property Owner Name Address Crty/State Zip Phone Name Address City/State Zip Phone • qi�-5�r3 �304 Lic # Address City/State Zip Phone r (Jll-l-%Y�i ItW- . /��7 --/9✓rfl ar...# a Contractor City of WConins sale& Tax # Are you paying taxes he re or by report? Here ❑ Report ��nwr'b�tsra�u��ddl'aAcaneaarars Are you paying with youirbust accounti!)KYes ❑ No 1s this a residential or commercial projew ,i` kesidential ❑ Commercial If residential, is fi ❑single FamUy Detached * CJa ido/townhome (single farnky attached) 11 Duplex' © MuMMHy (apartment) C1 Garage If aommerdal, is it ❑ Bank 13 Bar ❑ Church ❑ Hote/Motel 13 Medical office 13 office ❑ Retail 0 Restaurant ❑ Outer ( lain) Is this building 50 Vem of ape or more? r3 Yes to oyes, maYrae,er/m mntviceHis[ar/c PYesenarlon If this is for a demogeon PernfM, what year was the building constructed? IfMWr rn 1975, you MI/ 17MV an aSb� asses, =r to submlt wM t/rfsapplicaat/on. Of *If lawn sprinlder/baddlow preventer, must rut reamed plumber_ V firsMsme A/C, must tfist ed electrician. Subewdractors: Lr3tmecompwlyrameoraliyofRCb1hhg mseg l'Mber. Mectranical�. Rodier. other hereby ad=mledge that i have read this application and state titat the above lriformatioi n is complete and correct i agree too cOmPly requiremerft cortiaared herein and city ordinances and state laws regulatinio bin'Iding mrutrudion. = w.ow thpt a permlt is not valid IMM it has been paid and issued. Applicanir Prim Name:,, �d C LlLpilr' _ siignab"