HomeMy WebLinkAbout4130 SPRING CANYON CT - APPLICATIONS - 10/17/2014C Of. Pbnnb& Devdopment a T"nspottatlon
ort Cotl�ns � N. A�� �°
e`X�ver Phone 970-416-2740 fax 224-6134
OVER-THE-COUNTER PERMITS ONLY
This application Is to be used to apply tow the following permits only (ohack all that apply). O AIr Conditioning
❑ Demolition (interior non-tstractural) O Electrical Alteration (not sarow change) O Gas Lighter ❑ Om Log
❑ Heating Unit O Lawn Sptinlder O Mobile Home replah7errrent icing O Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line 0 Waod/Peget Stove (must be EPA certified, provide make, model and
manufacturer).
COMP10te all applicable Information an the applkadon. Incomplats abolicatlons will not be accer"d.
Application #0(q t(�3 3 Date
Is this a r+esldergW or eomme tw pr dew 02owsidential O Commerdal
If residential, is it: 'EFShVis Family Detached ❑ Condwbwnhame (single family attached) ❑ Duplex
V commercial, Is it; 1] Hatt* D Bar QKnch ❑ H�MoGd 0 Medical ofree ❑ office O ReM
❑ Restaurant ❑ Other (explain)
Is Oft building So years of mae or more? O Yes O No V ya4 yoo may need to la )oa hyst&* Auferoh%*
If this Is for a derneligon permit, what year was the building
ffP1 a'tv 197S, Yhav *W need an a0eo irxnt rb srudmlt be b* gapVkabarc
• • Jt1Y���'' rya- ___ /�• ����
*if lawn sprinlder/bKliflow preverftr, must list ®omsed plumber. If fb b me A/C, list Ike&n*W electrician.
Subcontrsctegm 1.4 t the cwq* W rare or aly of R a&W&&W#
Oecettlen _ PM"bv--� —_� MedwYgl:� Noota C��'WT' ptlter
• .loran 0w'0v =9e mat 1 nave read this application and state that the above Information IS Corm
comply with all (eg *ww is contained herein and dty erdinanrrs and state bws rAna pate auctIonect I agree a
Pmmlt d not vsBd unW it bes been paid mW awed.�d- cQrnsbuetfon 2 know that s
Applicantl
PMnt Nsrna: f C x[ f�
_ _:+fOsatirrrth Dote j6Vj
I d SOZ000009L 'oN/8b : 8I ' 1S/6b :8l b IOZ L 1100 (I8A) NO I iVV01S3a Dla N021d