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HomeMy WebLinkAbout450 CIRCLE DR - APPLICATIONS - 6/14/201206/14/2012 10:51 19702241211 ROCKY MTN ROOFERS PAGE 01/01 art Collins OVEW This application is to be used to apply for 1 ❑ Demolition (interior non-6�❑ Etact Heating Unit ❑ Lawn Sprinkler 13 Mobile 0 ventilation 0 Water Heater ❑ Water Line manufacturer). Complete all applio4de inf+orrnation on the Application #, B 19-0 31000 For cfiFte ase only Planning, moment & Transportation 281 N. College Ave P.O. Box 580 Fort C019m, OD 80524 Phone 970-4I6-2740 Fax 224-6I34 PERMITS ONLY ioliowing permits a* (check A alai appK 0 Air Conditioning d ARemIliaa (not service drange) 0 Gas Lighter 13 Gas Log me replacement Mooing ❑ Sewer Lim ❑ Photo -voltaic f WwWelfet Stove (must be EPA certified, provide make, model and Incomplete Woficadom will not be accepted. Date L&�4ZZ 2 Job Site Address (mgheg9 Value of Consbuction (tabor, mates, profit) 'f.SO &i-t? /e Dope., $ J 5 Do Property Owner Name 77.' r 'Ba' ins y5) CdiL/Z City/State zip IDIc T76 d65 1 Phone 75;G X= s' Applicant Name Addr WState Zip Phone Cont ac6or Lic # f. Ilf 3 Address ter S.IJI ( a y/State Zip 2 e_. F e, SGSz. Phone a{^?b Z2='-A-1-&oo Contracbar City of Ft. Colkins Sales Tax # t4 safes tax rumxderLs.rap~ byaBma&ac&m C.p Are you paying taxes here or by report? ❑ Here Are you paying with your truce account? )# Yes K Report ❑ No is this a residential or coff wmmrW project? AFR if residential, is tL btfbgle Family DLtached Multiramiy (aparbnertt) If Commercial, is it 10 Bank O Bar 0 Church © Resraw-ant O Other ( Is this building 50 years of age or more? Ct Yes If this is fbr a demallitian permit, what year was Irprior to 1975, yw writ need an mbesms as ssr Of enft 13 Commercial CondaAwnhome (stngle family attached) 0 DuAx Garage Hotellmotei 13 Medkml office (3 office E3 Retail *If lawn spnniderlbaddlow areverrter, must rst plumber. If flr!jtmw A/C, must�liist G m;ed 'an. ut>co Sibwtom - to bFre rvn pany^WM Or 0y cf Cbffirtsr effcm /Cc,/7�a�iGC� Eiecbldan Pkwix6 r I ftladianlcaL Roofer Other I h mvby acknowbe * that I tk we read this WPACaoand state tine a3mve afor lion 6 and correct I agree to comply with all � tong herein anti and state laws regula" bulWmg construdfon. I know that a permit is not varrd until itbas been paid and' . Appiicar� . Prim Name: pate -Tru5-f Arcc-oun+