HomeMy WebLinkAbout1148 SPANISH OAK CT - APPLICATIONS - 8/15/2014From: All Phase RestorationFax: (970) 622-2057 To: Fax: +1 (970) 224.6134 Page _14of-160811512ol4 8:28 • .:` `
planning, Development:8L:Titans
portabOn
F cityaf
281 �Aye
:Fort111C0ns ,CO80524 0 8ox 580 -
0 O�.�it1S Phone970,416-2740 Fax224,U34
01/ER-THE*C0UNTER ;PERMITS ONLY
This application Is to be used to apply:for the following permits only (cheek all that apply) . C7 Air Conditioning
❑ DemoliLon.(interior norrstr 04.. ij ❑ 1ppirical.Alteration (not service change). '1.1 Gas Lighter D.Gas Log
"0 Heating Unit: 1 Lawn Sprinkler -Q Mobile.Home replacement .Rooting CI Sewer Llne, . O Phato-voltaic ..
(3 Ventilation :O Water Heater 0 Wateri4ne. p Wood/Pellet:Stove (must be EPA certified, provide make model and
manufacturer)
Complete Rplicable information on the :application Incomplete applicatlons will not be accepted
Date A�
Applicah — T ..
Va coon Iaborr terial5, profit)
]ob Site Address (required) lue of Consdv
3
lip . phone. Ly 2 yr
property.Owrier Name ` . Address GtY/State
7D
5' cx-�• 5� 'Da,� -L�� I fD.A �53� r►'ir cLe!/r�„�%' ss'61
Applicant Name Address Gty/State Zip
Address Gty/state p
Contractor P one
All P/iate
re7a�56 b'As
Here Cl Report
fi�{ Areyou_. a in taxes here or by report k ..
Gpnttactor .Citypf Ft. Coll ns.5ates.Tax # • . paying 9
salGs.tarnvmberJs„,jr� nyeu.mnoaanr� Are YoL.:paYin9 with your.trust account ❑YesNo
is this a.residential or commerdai.project? . ` Residential ❑,Commercial
If residential, is ir.; Single Famlly.Detached 13 Condo/townhome (single family attadled) Q Duplex
Multifamily (apartment) ❑.Garage
If commerdal, is'it , El Bank ❑ Bar ❑ Ghurch Oia ptel/Motel ;O Medical office office ,t7 Retail C
C]:Restaurant ❑ other (ex
p )
�J
Is. this: building 50.years ofage or. more?::CIYes . j No Ifyes,.ryvymaYneed oconlactHisl°dcPreservat/on
IffihiS is foc. a demolition.permit, what year.was the building cons
llcadon._: • .
. �Ifpdo!;m1975,you:wil/needagasbeslns:assessmenth7.submitwlthti!iLs:app ...
Desccfption of work: _sg
if lawn spnnider/bacidiow preventer, must list licensed plum tK If first-time A/C, must list licensed •eiectriaan
Subcontractors List the compelnYname or Gty ofR Collins/Irense
_t
• ..
:.. :.: 6ectridan�_
Plumber Med!atuwl Roofer. Ot11er
I hereby adgwwledge that I have read this application and state that:the above :Informatlon is complete and correct.. I:agcee to
comply -with altrequiremerfis c�ltairled herein.and. city ordinances and state laws, regulating building coristnidion. i know.tfiat a
ills not.valid unfit it has been paid and issued.
pm+nI ,
MpucdM. Dade g't 54
Print Naii►e. �-- Signature