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HomeMy WebLinkAbout421 BANNOCK ST - APPLICATIONS - 4/4/201304/03/2013 11:14 970-506-2730 ALPINE GARDENS PAGE 04/12 Planning, Development & 7ransporh3bon 281 N. College Ave P.O. Box Sao Fort Cdins, Cl) 80524 Phone 970-416r2740 Fax 224-6B4 -OVER-4rIKE-COUNTER -PERMITS -ONLY This application is to be used to p apply for the following permits only (check all that apply). Air Conditioning © Demolition (interior non-shuctural) O Electrical Alteration (not service change) C1 Gas Lighte( ❑ Gas Log 0 Heating Unit O Lawn Sprinkler ❑ Mobile Home replacement Q Roofing ll $ewer Line CI Photo_voltaic fa Ventilation 0 Water Heater 13 Water Une ❑ Wood/Pellet Stove (must be EPA certified,,provide make, model and -manufacturer). Complete all applicable information on the application. Incomplete applications will not be accepted. Application # 6 1301yC3 For of m rwanfy Job Siie Address (aa2uimd) Property Owner Name Applicant Name Date _ ___.. L4 T a-L_0.0 Value of Construction Qabor, malx fiats, profit) Address C,Ity/$Tate b Phone Address City/State Zip Phone Address _ city/State Zip Phone Contractor Gty of Pt Coffins Sales Tax Are you paying taxes here or by report?'0,Herc C7 Report swes,tmreronAre you •paying with your mist account? O Yes IF No Is this a residential or commercial project? X Residential Cl Commercial If residential, is it:' . ❑ Single Family Detached 0 eondo/townhome (single %mily:Attached) 0 Duplex ❑ Muftffamily (apartment) ❑ Garage If commercial, is tt: ❑ Bank ❑ Bar 0 Church El Hotel/Motel ❑ Medical offio? ❑ t3ffre ❑ Retarl ❑ Restaurant la Other (explain) is mis building 50 years of age or more? . 0 Yes '1 No Iryes, you mayneedto canfactHisto cPirmnadan If thi5.is•for a demolition permit, what year was the building constructed? .rfpr/orto IR;3, you w7/need an asf>estas assas3ne7tto submIr wide iius apA&7.ion. Description of work *If lawn sprinkler/baddtow preventer, must list licensed plumber. If first -dine A/ly must W licensed electrician. Subcontractors,;/.istthemmpanynameart7lvofRLbpinsGcense� Decbiciatt Flambe$ �/� � +� Med>aruw�_ ;loaferOther I hereby ackn wledge that I have head, this application and slate that the above lnfvrmaSon is complete and mrract I agm to . comply wlttr all requirements contained, herein and city ordinances and state taws regula' i°g building construction, 1 know itxat a permitis ndYvalid irntil it'haw been paid°arid'lssudd .. . ... -//7 /