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HomeMy WebLinkAbout5220 Boardwalk Dr - Applications/Reroof - 05/26/2015 (6)Cii)I Of Planning, Devc-qopment &'transportation 281 N. College Awe p.o. Box 590 Iron Comas, Co MS24 Phone 970-416-.'2740 Fax 224-6134 OVER-THE-COUNTER PERMITS ONLY This application is to be used to apply for the following permits only (check OR that apply), ❑ Air Conditioning ❑ Demolition (interior non-elruotural) ❑ FJeetrieal Alteration (not servi a change) 0 Gas Lighter ❑ Gas Log El Heating Unit 0 Lawn Sprinkler O Mobile Home replacement oofiing 0 Sewer Una fJ Photo -voltaic ❑ Ventllation ❑ Water Heater C7 Water line Q WOod/Peilet Stove (must be EPIA certifi manufacturer). ed, provide mat®, model and Gompletu all applicable information on the appoemon. Incomplete applicaiiions will not be accepted. Application # B 150 LI 6$R- 'Me For ofte lase only lob Sibs Address &vgv#edj zW LYd oarx, Property Owner Name Address Al 1 Pro K &Yvf ag 100 5 Col Applicant Name Address 131: # Address nc • */P--1957 Contractor City of WCoflins Sales Tax # Sales laxMAAberrsragtr6r:dbyailCwR'id &S7 Value of Censttrelctian (labor, maberiais, profit) $ua^e--M�n city/State Zip Phone A•yt -FI"C $oSZS• g10-Z2tl-L1gq& cu/state Zip Phone 1D,53 ,3D8p W/State Zip Phone Are you paying taxes he re or by reporC? f1ere a Report Are you paying with youir trust account? Yes ❑ No Is this a residential or commercial project? )k1ZqddentJal ❑ Commercial If residential, Is it: ❑ Single Family Detached >1!�ondc/townhome (single famil+,r ached) 13 Multifamily (apartment) ❑ Garage If amurmVial,1S it © Bank ❑ Bar C3 Church 0 HooPl/Moml 17 Medical office ❑ Ofnco Is 0 Restaurant 13 Other (explain) this b ❑ Duplex w7dmg 'S�v0 years of age or more? 0 Yes o Xf yesr, you rWy need to mniact HiSirvric P71Mrtra[ion If,this is for a demogdon permit, what year was the building constructed? Ifpnzir to 1975, you wV1 naed an a bed= a&vwnenttn w1w* with t its applkahon. of work *If lawn sprinkler/back0ow p'reverhter, must list Rtensed plumber. ff first-time A/C, must Iltst licensed electrician. Subcontractors: 14stthe company name or 01y ofFt Caffins license .0 gettrfdan Plumber Medtanirai • hoofer Other I hereby admowledge that I have read this application and Wife that the above utFormatioi n is complete and correct I agree to mmPly with all requirements contained herds and city ordinances and slate laws reguiat D g bUWing construction. I knaaw tr at a permit is not valid until it has harm p-rd and Isoued. ApISHCRI >r Print Nam