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HomeMy WebLinkAbout637 Agape Way - Applications/Reroof - 05/06/201605/06/2016 10:51 1970 211 ROCKY MTN ROOFERS PAGE 01/01 !pity, Of rt Cottins OVER This. appiiccation Is to be used to 0 Demolition (interior non-stt udur 13 Heating Unit ❑ Lawn Sprinkler E3 Ventilation [3 Water Heater 13 manufacturer). t ornpkft all applicable informal Application #, For ot% rye arty Planning, Devidopnmt &Transportation 281 N. College Ave P.O. Box 580 Fort Collins, 00 80524 Phone 970-415-2740 Fax 224-6134 PERMITS ONLY ily for the following permits only (check all that apply). Cl Air Conditioning 0 Electrical Aiteratlon (not service gangs) ❑ Gas Lighter ❑ Gas Log Mobile Home replacement Xjioofing 0 Sewer. Line E3 Photo -voltaic er. Line - 0 Wood/Pellet Stove (must be EPA oertMed, provide make, model and on the application. Incomph to applications will not be accepted. Date A~ CSC 39b She Address (1WWVd) Value of Construcuon.(labor, materials, pri t) Property Own Name' Address City/State Zip Phone :503 Lpo I Applicant Name Qdr6 city/Stale Zip Phone —t� 3 w I w Zip Phoneg74 A<fc Rv.v j ► *.� faoot-.s F r4Lors . I�r y.�lC--�►.r,� C Cc'� - itY� Contractor City of FL Collins Sales ax # 4415 T4 Are you paying taxes here or by report? 13 Here Report 5iss<esrawrwmberEi•requAvebroff Are you paying with your tnrst account? '46 Yes ❑ No is this a residential or commercial p ec ? F Residential 17 Commercial If residential, Is It: • IRSingle Famip Detached 0 Condo/townhome (single family attached) Ica Duplex © Muitifamily ( rtment) C3 Garage If commercial, is it: 13 Bank O Ba 0 Church E3 Hotel/Mptel Cl Medical dfim [3 Office 13 Retail 0 Restaurant Q Other (explain) Is this building 50 years of age or ore? to Yes [$& No If yeg, you nWneed to.canW H/s4rk Pfvw vadon If this is for a denmglition p0rm11>;, at year was the building aonsdutbed? __tJA lfp wr to 1975 you will need an .assesjmMt to submit wiUi t&& apOlca&on. of work *If town sprinkler/baddlow pnwenter, Suboontracbalae List Me cagwny nm t list ticerised plumber. V first-time AIC, must list licensed electrician. orOtyofft.Colft hic ise 0 jAkVW4&j f t"%ij ". C' MedMical Roarer Wier I hereby admawledge that I have read is apprication and state that the above information Is eompleW and correct I agree to comply with all requirements contained min and NEy ordinances and -state Ion regulating bulldtng construction. I know tW a permit Is not: valid untik it has been►pald and israred. Applicant: r r. 6 " r 6 Pdrit IRame:_-- ®� �` Signature Date y