HomeMy WebLinkAbout4913 SMALLWOOD CT - APPLICATIONS - 9/22/201409/22/2014 17:12 8666038167 MECC PAGE 05/05
C� of Planning, development & Transportdtion
R ryt Collins
Fort N. College Ave P.Q. Box 580
` �r.� Collins, CO 80524
Phone 970416 2740 ' Fax 224-61.9
OVER-THE-COUNTER PERMITS ONLY
This application is to be used to apply for the following permits -only (Check all that apply), ❑ Air Conditioning
O Demolition (interior non-structural) 0 Electrical Alteration (not service change) L3 Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation d Water Heater ❑Water Line ❑ Wood/Pellet manufacturer), Stove (must be EPA certified, provide make, model and
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application #�F-1�-iCDO 0 0q— Date
For ofte use only
Is this a residential or commercial project? kResidential ❑ Commercial
If residential, is It: ❑ Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ office ❑ Retail
❑ Restaurant • ❑ Other (explain)
Is this building SO.Years of age or more? O Yes 13 No If yes, you may need to conia&Histor/cPreservation
If this is for a demolition permit, what year was the building constructed?
Oprlorto 197F,, you wi//need an asbestos assessment to submit with fhisapp/ica#on,
Description of
*If
preventer, roust list licensed plumber. • If first-time A/C, must list licensed electrician.
SubContraetors., List the company name or aty of Collinsl/censs #
Electrician • Plumber Mechanical : a
Roofer � Other
I hereby acknowledge that I have read this application and state that the above information Is complete and correct. I agree to
comply with all requirements contained herein and city ordinances and state laws regulating building construction. I know that,a
permit Is not valid until it has been paid and issued.
Applicant. -
Print Name: f ,� Signature Date