HomeMy WebLinkAbout4719 CREST RD - APPLICATIONS - 9/16/2014ThIsapiloofjori Is tio'be Used toapply for,the-following perMIt5CntYLCnQGK all w2lapplyi., W^jl %.uIIUjuujjjjj:j.
Cloamorftn(intgriotrion.bimutuMI) p.EjecWcal Alteration (not service change) 13Gas Lighter CGas .Lag
13 Mealfrig Unit 0 Lawn Sprinkler 0 M' HOMS replacement Roofing C3 Sewer Una! 0 Photo -voltaic
a Vttngja&n' [I Water Heat" ri livabr Una . Cl Wooff east St6ftie (must be EPA carmed, proVide fnala% madel and
manufacturer):
Complete all avoliclable, information on the alipilootion. Incomplawalpoliciationr�Will,n,ot.be'adcept$6-1
Appllcatlon.#
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Job Site Add (120ften), VMUR of Construction (labor, matula% pmfit)
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praperty.OvAih . erName Address City/State Phone
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,Applicant Mama Address Phone q-Acr
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Contract6s Address dwsutp zi Phorte
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Contradur City of Ft Collins Sales 7ax 9 'Are yOU.pay.ng taxes hum cr by ere1:3 PA30it,
Are ywpaying with your trust account? ea 0
Ts this a, residential or cornmerd-al predect? MrPja!9dmftI CI ownmerdid
.1fresidental,lGit: JZ Single Family Detached 13 Q*aQFtj;*hoYna (Angle farlily attached) 13 Duplex
13 m6W6mUY ftaftfnant) Medical office 0 6�fae b
If ca M-6erdal, is El Bank E3 Bar-. El Churdh O'HoWkiitld
Retail
0 ReMurant 13 Other (e)lain)
- this buildft 60 years of gige or mom2 El Yes ' El No rfymr MSWC
Ls . pYWInaYnmdI0E*&�
It this IS &r a dame Man VeMit what year was thikbuilding aOrWncfi ..
rpearh2jim, YOU k.01nwd-m7 a
_.YL? Z TP 71.i�777
nu# JU acansW plumber. IF flist-time Afr, must list Itcarm;ed elec6lclam
Subcontractors; L&rdwc=Avnynafn-,cro;y*fFtCaWnsIA2nso=
m Roofer Other;
I hereby admoW . a I d9s tbit I have read this tpplicatIon and!
,Calipjy jVjjjj ali Taquingments contained hendn and ct01 Wdif
pqffW,t7js not valid until it has been paid and issued.
to strove Inkirrnation is o6m,pete and 6r'rem
state, laws mguWng buldIng CoristructiOn. I
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