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HomeMy WebLinkAbout730 Sandpiper Pt - Applications/Reroof - 06/24/2015CtI a f Pianding, Development & Transportat,on F-rt Collins ftCoon 00 BDS24 0 Phone 970416-2740 Fax 22+6134 OVER-THE-COUNTER PERMITS ONLY This application is to be used to apply for the following Permits only (cheek.all that apply), © Air Conditioning 0 Demolition (Interior non-structural) 0 Electrical Alteration (not service change) 13 Gas Lighter ❑ Gas I pg 17 Heading Unit © Lawn Sprinkler 0 Mobile Home replacement' 0 Roofing q Sewer Line M Photo -voltaic 0 Ventilation 0 Water Beater 13 Water Line ❑ Wood/Pellet Move (must be EPA certified, provide make, model and manufacturer). Complete oil applicable information on the application. Incomplete applications Will npt be accepted. ' ApAlicdtion # �DOO�� pate 3 u �00- 2 �15 rorofike mr ort/y Job Sine Address (narrbed) Value of Co ton (labor, matadals, Profit) Property Owner Name I Address C Zip Phone . k sti . % I tY/Slate Applicant Name I Address qty/State Zip Phone J rJenJ e M_, MR AdTIA)6 - A5 B.lou� o a Contractor 6 Adc mm awstat a ZIP . Phone Contractor city of Ft: Co MMISales Tax # `' Are you paying taxes here or.by report?'3(Here 17 Report Saks �rrwnY>era rpgte]s3dbyer Are you paying with Your 6tist ac oury XYes 0 No Weev%&'e AL p-fg} Is this a residential or commercial project'i O Residential 0 Commercial If residential, is it Singi I lRafty Detached p Condo/pownhome (stngie family attached) p oWh!x 13 If commerdat, is it 13 Bank 113 Ala Church 13 Md*VMotel ❑ medical otrwe 13 oPfloe o Retail Restataant 0 Other "explaln Ts this building So ymm of aye or more? ■ No JT^ you rrh7ynNOd aO Cvdvct AYstolYePA2onsyan if this is for a demolition P96nit, what year was the building constructed? rprtorto,t94pit WSneed:kvaskMSa0RWN t,bSU&fltWea&4Cplha-ffm- Deso"on of work *If lawn sprorkier/baddtow Subcostracrins: L&Agec Becpfd 1 henry aci rimledge that; comPly With all requirements permit Is not valid unb71! APPIllcant: Print NAm, must list Gcen.ed plumber, If first-time A/C, must list licensed ekxbiciari. orCWoft?COMits/ W&M e Med rdmi_ Rflofer Other Mill this apppcation and state that the above Infonnation is complete and comet I agree to aW herein and city ordinary and statatir" regplating bUldiDg construcft. i know that a been paid and lsaued. Sigrwtare b1�� "5