HomeMy WebLinkAbout4403 MONACO PL - APPLICATIONS - 11/15/2011Nov 16 11 12:52p FM Roofing Inc.
1-970-221-8526 p.1
� 9L
Fort �ol[�ns K lw -A,e pro.
Fort ie 97 CO 7,W
0524
Phorhe 970.416-ZI40 Fax 2246134 .
OVER-IME-CC! UNTER PERMS ONLY
This appkieation is to In used to ahpply for the fo®owhV pennits only (chackall that apply). II Air Corhdrtioning
❑ Demotion ('m6e W rwnr-slr�ctur t;� 0 Ebobbd Afteraf�rt (not service grange) ❑ Cos Lighter 13 Gas Log
❑ Heating Unit ❑ Lawn Sprinkler 0 Mobile Home replacement 11Rooft ❑ Sewer Une 0 Photo -voltaic
❑ VerMadon D Water Heater .0' tiler Line El Wood/Pellet Stove (must be EPA cerOfieck provide meks, model and
mermlacUner).
Complete all applicable inlion hed Im on the application.
Apprta" #_.__ P 1 110 GO lO
For ffie 01*
kwompfeie appOcations wM not be accepted.
Dave
I Deb see AiWrew
� `f o 3�q� Y�� � I a r�_ � vote ofoon�rucrson (ram, , Imo) f
Property Owrw Name - Addrm
61Y/Stte
Zip Phone
AppCaant Nacre: Addrew.
CI Y/State
Zip Phone
Contractor Lic # Address
City/Slate
Zip Phone
Rk Roofing Inc. R-400 1629 S.
I.emay Avenue Et. Collins, CO 80525 970-221-1388
Cortbatmr City of FL Cadim Sales • Cax
Are ym paying I , here or by ® Here ❑ Report
Safer tarmon&wArr w~4yafmrbaaars 18596
Are you paykh9 with
your bust acoourV7 D Yes C& No
Is the a residential or commercial prglet? 0 Resiid ti . ❑ Conxmesdid
If resideralal, is it: 0 mingle Fend y Detafied ❑ Card twrhorw (single firfilb Q Dupkx
p MuWamfy (aparbnent) 0 Garage
if aommerdak is it 17 Sw* El Bar ❑ Church 0 Hub~ ❑ Medfd office 17 Office 0 Rh�7
- D Rest3rawrt ❑ Ottner (explain)
Is this buBding 50 years of age or ivore? l7 Yes O No B°yeg yrau mayneed a7 mrXP, r ? h tj*Prtsanaffw
If this is for a dernogtlon pen ft n drat year was the building constructed?
Ifpniorlb1973; youcv�Biceedanas���aueattos�udne?»�Jidris�gaGmtkmr.
*If sawn sprMer/badQbw prewutw, roust MI homd plum1w If fsstfime must list licensed elechiclan.
lfstlhe camimWmw ore arClyeA' Cai'htsdl:ease if
k.1 .
I hereby ad nowtedge that I lave read this apron and slate that the above irdannation is complete and otin I agree to
oompt,► with au re &&eras writillned herein and dty ordinances and state taws reFfia ft WUMM consbucborh. I know not a
permit b not valid anti! it has been i paid and im*d-
Prw : _ Skjrd +e