HomeMy WebLinkAbout1924 Ross Ct - Applications/Reroof - 12/19/2017Dec 19 2017 17:38 RTC 9707763741
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,Foil Collins
This application Is to be us
❑ Demolition (Interior non-st
13 Hesting Unit 0 Lawn Spi
0 Ventlellon ❑ Water Heat
manufacturer).
Complete oil applicable ird
AppkiiiVon #
Farantoe we
Planning, Developn lien4 & Transporbdon Services
Community Deve opment & Neighborhood Services
281 Norlh CoUege Avei Kie
Fort Colin, CO W524 Mein: 970 4162740 Fax: 970224.6134 c
i
/ER-THE-COUNT�R PERMITS ONLY -
to apply for the followin4(ot
Its only (check all that apply). 0 Air Conditioning
tural) ❑ Electrical Altermetisendce change) ❑ Gee Lighter ❑ Gas Log
ter 0 Mobile Home reply'�tooflng ❑ Sewer Una 0 Pholo-voltalo
17 Water Line 0 WoodlPove (must be EPA cert fled, provide make, model and
nation on the application. Incomplete applications will not be accepted.
ti
lob She Address (lawkod)
Value of Construction (labor, materials, pm t)
Property Owner Name
Address ,
! City/State zip Phone
5
Applicant Name
Address
City/Sate Zip phom
-
E 4�
3-3•t(7n
Contractor
Address
city/gate Zip Phone
I
CoAactor City of Pt. Collins S
tmm here or by rgmv JVHere ❑ Report
des Tax # 7Arepaying
paying with Your trust aaoount? ❑Yes )VNo
Is this a residential or corn
I pro]ett? 14 Res el
t
If residential, Is its 0 Single
Ily Detached Condo
tame (single family attached) 0 Duplex
O Mum
ly (apartrnent) 1nn7 Garage
If commercial, is It: 0 Bank
Bar ❑ Church O Ho*Mob
1 0 Medical Wise 17 Offloe 0 Retail
D Restau
nt ❑ Other (explaln)
Is ft building 5o years of all
If this Is for a denwgtlon
or more? 17 Yeso hr
what year was the building ot
ym, may need to G7naKr H RvmfyjVw
nsbucbW
of work
Qe A�j
77 fA.0
*If lawn sprinider/bacldlow
OL
, must Rst llowsed plumber. I
flrsb4i ne A/C, roust list licensed eieMclon.
Subcontractors:L&ft
nsnmeorLlyofFtchwns
0
Plum
MedtiolwlT,
pgp�r�— Obw
I hereby admmvledge that I have
comply vrith all requirements
wd this application and state ttw
ed herein and city ordinances
the above information Is wnpiete and correct. I agree bo
Permit Is not veld until R Irss
of
paid and le usd,
state laws regulating building construction. 1 Imoms that a
Print Name:
ISIpnabne
Data 1� /
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