HomeMy WebLinkAbout2921 Timberwood Dr - Applications/Water Heater - 02/28/2018Planning, Development & n portation
281 N. College Ave P.O. Brno 580
jns Fortcolt, ao 60524 -
'�-� Phone 970-416-2740 Fax 224-6134
OVER-THE-COUNTER PERMITS ONLY
Is application Is to be used to apply for the following permits only (check all that apply). 0 AirConditioning
Demolition (interior non-structural) 0 Electrical Alteration (not service change) ❑ Gas Ughter 0 Gas Log
Heating Unit ❑ lawn Sprinkler 0 Mobile Home replacement ❑ Roofing 0 Sewer Luce 0 Pholo-voltaic
VentilationjAWater Heater 0 Water Una ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
all applicable infommation on the appileWon.
�1 #Y �] AR-0 13.1
Incomplete applications will not be accapted.
Date 2&ga��'
ite (nab
Value of (labor, materials, profit)
WUGY�' �- —ZZ Q
rHCQ�Address �5�5 clty/Sta 07�tip
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447- - S70r7
ant Name Address
City/State ZIP
33iZ
1�/5t!
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AJS 8052
tractar i911M f9?�IN II �-�W Address
City/stage Zip
0 VW Zo
�EaVuC
3-31
n
tractor City of FL Collins Sales Tax ;i~' ZOa
Are you paying taxes here or by report?
❑ Here A sport
ftrmmrbwjsmgAWbyafwahx m
Are you paying with your trust a:courvO . Yes ❑ No
this a residential or commercial project? ZAesidential ❑ Corm ercial
residential, Is is 3!�5tngle. Family Detached 0 Condo/bownhome (single family attached) O Duplex
❑ Multifamily (apartment) ❑ Garage
commercial, is It ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medial office ❑ Office ❑ Retail
❑ Restaurant 0 Otter (explain)
ttis building 50 years of age or more? D Yes D No If yes, you mayneed to cwt3&h&*ecPnwrtrabhn
this Is for a demolition permit, what year was the building constructed?
(prior to 1975, you will need an asbadas az;mwnent to submit with tba aAakaifan.
of work
74
lawn sprinklerPncidiow preventer, must Ilst licensed plumber. If first-time A(C, must list Rcen ed electrician.
Licit the cwWnyname or 0y afRCoNlns ffcw e #
Piunber - MeftnkalL— Roofer
hereby acbhowledge that I have read this application and state that the above imbrmation is mmplele and correcL I agree to
xnply with all requiveraw is mnteirted herein and city ordinances and stein laws regulating btulding construction. I Iorohmr that a
ermit Is not valid unlZ Ilt has been paid and Issued
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