HomeMy WebLinkAbout630 SKYSAIL LN - APPLICATIONS - 8/12/2014%OPT wwffs`s s,MNM %d@t %&VVj a 2=8'M a EaeE1dII8B
This application is to housed to apply for the following permits only (check ail thpt apply). 0 Air Conditioning
0 Demolition (Interior non-swchnap ❑ Eiecitk at Alteration (notsesvlce change) ❑ Gas Llghter D Gas tog
0 Heating Unit 0 Lawn Spunkier 0 Mobile Home replacement )K Racing 0 Sewsr Line 0 Phota-voltaic
0 Ventlefton 13 Water Heater ❑ litttar Line CI ArVocdlPelietSilove (mustbe EPA cartiffed, proeide make, model and
manufeehtrer)_
Complete all applicable Information on the application. incomplete applioattona will not be accepted_
Application # 2>1+0U0310 Date
Foroh?w use00
Job Site Address (rsm sari)
valueofConstruction pabor, materials, graft)
1Q30 Sly-l9a,.i 1 L
5 r Sap.
Property [moaner Name Address
City/state 73P Phone
CM +'D�0,.ner SheLV\n,or,
SA,M6 9 G-982 -
Applicant Name Address•-
City/Stote Zip Phone q-W -
AJ 44ok 'Poch+ Tin at�i w. Tt�ih ttd� ce 8ro5aS a.o-7-o60a
Cantrams Address
ty/State ZIP Phone
Contractor City of it Collins Sales Tate
Are you paying taxes here oe by report/ 0 Report
sylor
Are you pvying %Hitt your trust aocounV Lr3"Yes ❑ No
Is this a rsskienual or commercial proms 911e iderttal O C3om01erdsl
If residentlal, Is it M Single Family Daiadtmd Cl Condol�nhome (single family agad� Cl Duplex
0 MultiFamlly (apartment) 0 Garage
If commemmi, Is it, ❑ {lank 13 Bar ❑ Churdl ❑ itOWIMotrl ❑ Medical office ❑ Office 0 Retail
C] Restaurant ❑ Other Cexoaln)
Is tMs building So years of age or mare? O Yes M No Ifyas, yo(t maynead fo �itactfffs>bvfc rvallon
If this is far a dernalition perpdt what year was tht='building eonsbnictbed?-
Ifpn'crrb ISt7� yea wlllneed anBsbastasassassnraatlt�submitw6tli D'rlsapp!l�tion.
Description of
*If lawn spnnderlbsddlaw Pre afftr, must Ma licensed plumber: If firse4lme Afr, must list licensed elecbbdan
Subcontractors: Gist OriacompanynameorQ4'ofRLb►IdislicPnse s:
9edrt��^ Prrtrttrer Mer7ranimi_ Roobar other
�- i SSq —
I hereby admowledge that I have read this appliralion and state thattha above rnibmMlOn is complete and maecb I agree to'
comply wlU► all mquirarats eontatned harr3n and dtV ordfianees end slate haws regulating bl>iiding construction. I knwm that a
permit to net valid until tt has been paid and issued. ,
Print ant[ . Awm �e vw� i S Slgnalurm �,;�_
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