HomeMy WebLinkAbout4349 KINGSBURY DR - APPLICATIONS - 7/8/2014Jul. 8. 2014 1:06PM ADVANCED ROOFING No•7351 P. 1
Planning, Development & Transportation
Z81 N. College Ave P.O. 8cx 580
Fort Collins, CO 80524
Phone 970-416-2740 FaX 224-6134
OVER4HE-COUNTER PERMITS ONLY I& 131'5 7
This application is to be use,,.'to apply far the following permits only (check all that apply). n Air Conditicrning
Q Demolition (interior non-structural) Ln clacticai Alteration (not se, -vice change) ! � Ges Lighter Gas Log
G Heating Unit ^ Lawn Spr'nk,er C Mobile Home reoiacsmer Rooting Q Sawer Line C Photo-vo(taic
❑ Ventilation Q Water Heater ❑ Water Line' Q Wood/Pellet Stove (must be E?A cart,-fiad, provide make; model and
manufacturer),
Complete all appii able information.(o�n the application. lnonnpleis applications will not be accept°~'.
Ap6licaton * I �, a Date
For orfce use of
Value �f Car stti Jct'lon (labor, matcr4eLs, ,"Jr,^, t)
--) f--1 C O
Property Owner Name �ddre<s
Crr{/State
Phone
tin < C^
��rpSS
l(c / 31 '
C
icant Na , Addrew
Cm//5L2te 1p.
Phone q-70
zta)P-4h&—�F,n6 Rvks Ly-Q& 6eni5
U kl C Wi6dsoe Co
&&a -n'->03
Contractor Lic r Address
city/stgte C
Phone
L\ cSI^'sMQ,
Convactpr sty of F i. Collins $ales Tax ri
Are you paying to es here or by ,zper*? Q Here
G Report
Sa/esv3xnumCBr 2au(radCY3nc�rt c'�s
Are you paying with your li'Ur <ac_ount? Yes
67 No
Is this a re siderrtal or commercial projee-v Resdental ❑ Conm„erdal
1.� rtsidentTai; is it• • • • �� Single Fanityr�'e.ac5ed" ' C] Con'cb/tt;o-r?�e (5{tigle f?inily at"u;Gi�j �? Duplex
❑ Multifamily (aoatt ent) 0 Car ge
I` commercial, is it: ❑ dank ❑ Bar ❑ Cnumh O Hctel/Motel L- Medic-i cmce ❑ cr ice ❑ Rstail
❑ Restaurant 0 Other (Main) ��n
is this building 5G years of age or mare? ❑ Yes �NNo . if yes, you nzy reeg"tO corl,-Z h'tstonc P, �E<r4 aror
if `ulis is for a demolitioh permit, what year was the building consu icted?
L`prlor to 1975, you will neee an asbestos assessment to subrnr rnc, this aop(Icrabn.
0 i!
iawn sNrVkler/baCralow prevente, mutt lip licensed plumber, If },rs .me A/C, ML, , ;is ikensed e:�ric an.
5uecontxac`ors- L4FL tew ompel- ran, e or Gbj cr'Fr [c//fRs lc --use
cEjec;ricrnn Flum-�ar.
mew,lanicJ Roof& � �� r]t,C, _
I hereby acicnowleedge that I have read thfs applicracn and state " at the above inromation is complete and correct, i agree- to
cbrlipfy witn,all require-nen- cor`ined heein area r'ty ordirznces and state laws reculating buidinc Cons uc len. E know that a
permit is not valid until it has been paid and ssu�
Applicant: �J� 1�✓11a
Print NarnefY0j 1 �C�. Slgn [:lie j Date
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