HomeMy WebLinkAbout2633 Pleasant Valley Rd - Applications/Reroof - 07/25/201607-21-'16 09:51 FRONT -Premier Roofing 9704848308
T-523 P0003/0003 F-968
aty of Planning, Development et Transportation
281 N. College Ave P.O. Box 580
.Qrt Collins Port Collins, Co 80524
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 all that apply).11 Air Conditioning
:__..�pt�emolitlox�_(intecior_na2stcuotura!)_.p Electrical Alteration (not service change) .0.Gas•Lighter--Z-Gas Log—•-•- • - --
17 Heating Unit d Lawn Sprinkler 0 Mobile Home replacement X Roofing t7 Sewer Line 13 Photo -voltaic
❑ Ventilation 1:3 Water Heater ❑ Water Line 17 Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable Information on the application. incomplete applications will not be accepted.
Application # 8 ur D q;24-4 Date _ Iz �//
For of a use onty
Is this a residential or commercial project? AResidential Cl Commercial
If residential, is it: ,'Single Family Detached 0 Condo/townhome (single family attached) Ci Duplex
D Multifamily (apartment) O Garage
If commercial, is it, ❑ Bank ❑ Bar (] Church 0 Hotel/Motel 13 Medical office [3 Office 0 Betail
M Restaurant O Other (explain)
Is this building 50 years of age or more? 17 Yes Jl No lfyBs, ylou mayneadM tant�c#H/storicPresprvadnn
If. this is for a demolition permit, what year was the building constructed?
rprlor to 1975, you w111need an aOestns assessment to submit with th/s application.
Of
V lawn sprinkler/backfiow preventer, must list licensed plumber. If first-time A/C, musk list licensed electrician.
Subcontractors: L& the companynamear01YOfRC011lns/Icefl-lw f'
Electrida Plumber Mechanical Roofer- Other
I hereby acknowledge that I have read this application and state that the above information is complete and correct. I agree to
comply with all requirements contained herein. and city ordinances and state laws regulating building construction, i know that a
permit is not valid until It has been paid -and issued.