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HomeMy WebLinkAbout524 Crestmore Pl - Applications/Reroof - 05/28/2019Fort COLUns - Faft- 8M4 Phone = 47.1ib-2740 Fax 22"IN OVER=THE-COUNTER PERMITS ONLY - This application is to be used to applyfor the following pemft only► (check all that apply)- Onrcondffiorft 0 Demolfion Cm tedor non-str�ra{) 17 Electrical A%wabm(mt*ervice change) ❑ Gas Lamer ❑ Gas Log 1] Healing Unit ❑ Lawn Sprudder 0 Mobile Home replac ment O Roof -mg 17 Sewer L'me O Photo-vottaic ❑ Vermlatm ❑ Water Header ❑ Water Line 17 WooWaet Stove (must be EPA certwed, provide make, modef and manufacdrtrer). Complbe all applicable information on the application. Incomplete applications will not be accepted. Applicatron # Cb I q 03 lQ S Dane For me mw Job Site Address (re edas9 Value of Corteruction (tabor. pit) 624 DPP-o",-WC PGhLcZ$ 7_ /50, dd Property Owner Name Addrem CrtY/State Tip Phone 770 Man c c&// /Z co (Lu 30-1M 993 -82`75 Applicant Name Addrm Cty/State Zip Phone 7'r U#ti D keSS - - - - Iq /8 contraftr UC # Adder ft:O fe-5 A liu-�: f d , Bo, Conira bDr My of Ft Coffins Safes Tax # S�Ir�tSfc�lierZs�agri[adbpaPc�ra�s mid Ap Phone 53 C�el�•yGfNIO qo-44-9' 470 -4a7-goo Are you paryng imces here or by repot? © Here Are You paying with yourrat acooctriV Q Yes ❑ Rq)ort ❑ ft Is this a reddeniial or corm m=U project? g Residential ❑ Oonmuerdal ff r 1, s k 0 9VIe lady Deadhed I] condoJtnwnhorne Cstgfe faimgy attached) 0 DWmi . L] MdWbmgy► CapartmenO D Garage If commercial, is Fe I18ank O Bar El Chinch 0 Hat~ © Medical office ❑ office ❑ ReWl © Resiarsant ❑ Odw (main) Is thisb E&V 50years of age or more? n Yes U M ffy� i� �Yneed to fi�riscPr�va6hrt ffths is for a demolition penuk whatyear was the buldfimg c anstrucbed? ff/aniar�1975 ytx�x+�r►eedarraa�ar�ins�biiulwr3fiUr$app6�oix . - 11)e�-on of (:GegS S- *Hlawnspmmerfi cdfnwprejerdter,mustustfwensedomrAw fffaa-urteAfc mtatf6tumnsedeEdncorL Sn6mr>ha- " -Lrtftcoo4 Wj7amearCffyafaCaMshbwme# jah Pk-d)er Rooler ;LC othm I hereby adma iedgethatI hate readths air and sial ethatt heabom 5dmmahm is mumiebe and aonecL I agres to aomph/wifh ail r+equ�errrads mt>famed f►ere'sr and �fl ordnuateoes and sidle laws regsfaticrg 1�9 t�adsn. I fkaow tirata pomaism*vaMumMithmbempafdiffidbsuaL P&* HOOKL fir U 1 ,,0D-, ' 5-V $ V /`> `l Date 5 �'