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HomeMy WebLinkAbout4436 Starflower Dr - Applications/Reroof - 04/03/2015From Affordable Roofing Inc 1.970.207.0289 Fri Apr 3 16:48:57 2015 MDT Page 2 of 2 �Q'Z; ©X planning, Development & Transportabor, For Collins:College Ave P.O. Bo>: 580 (4 Fort CO605Z4 Phone 9;0-41.6-2740 Fax 22d-5134 01/ ER`THEE-C"M NITER PER @ 835 UNL E This application is to be used to apply for the Following permits only (check all that apply). 7 Air Conditioning ❑ Demolition (inferior non-structural) ❑ Electrical Alteration (not service change) 7 Gas Lighter J Gas Log -7l Haetino Unit Q Lawn Sprinkler Q Mobile Home replacement G Rooting G Sewer Lira ❑ Photo-vol, 0n Ventilation Q Water Heater ❑ Water Line WoodlPeilet BiQvc manufacturari. e (moat b= EPA car•.i :,aed; provide make; model and �,Omplete all applicable information on the application. Incomplete applications will not be accepted. Appi!fcation =_MOIAC� Date For orrice use only .30i, Site ilaeirass (,�qui;ad) V rue of Construction (tabor, materials, proFit� �lao� ) j Propert/ Owner idame Address --- --__ - -__ —. t rass CiiyJ=face Zip phone ins zlZ i? )pncanr !`:gin ie j .1 % ` .� AddressCity/State Phore! Zip r iU 1 � i TC ���� aoi-000ri Ccm� a�:.or Address, state =tp Phone i i Contractor City at Ft. Collins Sales Tax -- - _ rsraxq�rt rrsre�ursdbiaUtontfact Are you paying with your Trust account? y,s �t Afa is this a resideniiet or coinrrerual ro 2�? C] Co — - :' 3 Rsidentiai mmercial ff residential, is it: �sinole Family Detached ❑ tondo/tw onhome (singie Pamiiy attached) 0 Duplex �lultilamilY (Wartmant) 0 Garage corr�meraal, Is ti: ly Bank ❑ 83r Q Church ❑ 40 jfMotel ❑Medical once Q tJfice ❑Retail Restaurant Q Other (explain) is 'ONS building S0 years of age or more? ❑ Yes ❑ 1\io I; 'f r= rnis is cr 2 etemo4ition permit, whit year .•ras the building cor>s_ tct��17 need to tvn,a7Hist0 CPr'aoruetion «g ivr in 1975, yQU will need an asbestos assessment tO svbmir rriin ch s aop/lcairon. Descri,ot'iOn of YVCrii ­�_c pr--�'�`— - >f 'r1 • �-i, 9 i!] `b . _. _ i t�►C l' 4 hJc! cif icon s dnigr_r/backilow reverter must list license b P d oturn er. If rir5-time /C, must list licensed elemorician. Sebcontrac:ors Gist ayecwncgnynameafG"iyofI:;-Cnllinsiicens ier•iCi2q_ Plumber MztnanlcrJ - -- Rona �1i45`..^ order__ i - � :�: �::t o"i,vvrcuye mar i nave read this application and state that the above information is complete and rorrscL I agree to 0',Vy !vie all requirements Contained herein and city ordinances and state laws regulating building construction. _'know that a ;.ermi is not Yaalid until It has been paid and Issued. 'nntName: iSignature