HomeMy WebLinkAbout1809 WILLOW SPRINGS WAY - APPLICATIONS - 8/15/2014Aue•15. 2014 3:12PM ADVANCED ROOFING
No•7536
City of Planning, Development & T'ransportaten
p-�••-■ 1 N. College Ave p.0. 30x 580
-��� �0(�(i15• •' 28Fork Collins, CO 80524
Phone 370-4.16-2740 Fax 224-6134
AVER -THE -COUNTER PERMIT'S ONLY
This application is to be used to apply for the following permits only (oheck ail that apply). G Al, Conditioning
u Deiroiition (intsrior .non-structural) n Eiectricai After;ion (not service chance) Q Gas Lighter U Gas Log
D.Heating Unit Lawn Sprinkler 0 Mobile Home reol' merit ^ r?OGting ❑ Sewer Line ❑ =i3OtO vcl aic
❑ Ventilation r w/atar Neater �3 Water Line 71 WoodiFallet Stove (mu
manufacturer). st be EPA certified, provide ,,",eke; modal and
complat p ca in'• ra4,-n !' a on
AnPI1e2b i
3ab _Ito Address
Property Owner Name Acdress
A �o
��fplicart Na ne
ITV R-NGE?'U P,DD � 1 NCB Ac'dr ass
Contractor y
Lic m Address
Ccrit•actcr City of r% Collins Sails Tax
Se/es tUr nunbe' &WLarae byiff =trVC uM
aaoSID
Incomplete applications will not'be accepted.
Da-M _ 5�
Vaine Of CQftaiructjon (labor, rnater:als, ,7fbf:t)
rc/Stete- 1- Cc/l,'ws Zip ec-s"D S' 7phone
co�c,
C ty!State ZIP, phone
C`y/Ste Zip Phone
Are you paying'taxes here or by report? ❑ Here ❑ Repot
Are you paying with your oust account? ❑ Yes ❑ No .
Is this a residential or commercial proje! ? XResldential ❑ Commercial
If residenwal; is it: XSingle•;==mily Detached ❑ Corrdb/townPotiie (snigje farn,7y attached) ❑ uplez
❑ Multifamily (apa,:unent) 0 Garage
If commercal, Is. it ❑Bank ❑ Bar q Church ❑ Hote!/Mctal ❑ meilcal of'ce ❑•Orrice ❑ ,Retail
❑ Restaurant ❑ Cther (explain)
Is tffis.8uilding 50 years of age or more? Cl Yes ❑ No IfMs, you mey neerrto con"}r r _L ric Pi zcerial7on S�
If this is for a demal tioit permit,;, what year was the building constructed?
tferror to 1975, you will need an Psbes<...s asseSSM, ent to submit wiGS Ghis applicar'cn.
Description of wod<
*if (awn sprinkler/bactdlow preverter, must list licensed plumber. if first-time A/C, must its: licensed ele t Ic art•.
5ubccntradors:Lernecomwryrenecr•cfryerF<Cz�trinsrcense> 17. ,
e ct--idzn ._, Plum . ber
N°r7anial •-- Itrofer
Other
Thereby aci(nowleyez that I have read this apeticaucn and state that the above Information is ccr:;piete end cOrreri
con pry vriti,all reguiremen� con irted herein; and city ordinances and state laws regu!at ng bulicing cone"uctlor,, I
Permit IS net vzlid until it has been paid and issued.
Applicant: L1 �
GPI'` �
PrinttName;Nae, .Si9nature
• �� bate
1 agree w
know that a