HomeMy WebLinkAbout642 MARIGOLD LN - APPLICATIONS - 11/20/2014This. apPlication is to be used to apply for the following permits only (check all drat apply). CI Air Conditloning
Cl Demolition (inierior non-stntcturai) ❑ Filecfical Alteration (not serulee change) ❑ Gas tighter ❑ Gas Log
❑ Healing Unit Q Lawn Sprinkler ❑ Mobile Hame replacement � Rcor7ng M Sawer l-lne ❑ Photo -voltaic
❑ VeniTie- on E! Watar Heae p� r uy3ctr line n tvoarlPallat 6tove (must he FT A aariined, pmulde mak% model and
manuacturer).
Completzall applbeable information on the application. Incompleffi app]icRtiens will no: be accepted.
Application Y I LI I I q �.� Date 1 "Z01
For Office use only
Jobs sits Add: ess (rapnirrd)
Value of Cons' -ruction (labor, ma staria% profo
t
t 1
Property Owoer Name Address
City/State Zip
Phone
1
� Vl JnyNeS
A -I r�- 9-70 - I'7
-17
.Parr
Address
App)lCantNrr��amtte
City/3tate ZIP
Phone 4,7G-1
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G- 7-0doa
contactor Address
wslat.- Zip
Phone
COTIVact ar City of Pt. Collins Sales TeX
Ara you pay"mg tamps here ar by report? djere O Report
salt, raxnumb� u m�ulr�br�i
ev e you paying with your trust account+ �fYes
U No
is Hs na.-MenVal orcommardal proyect7 tlResidensal P Commercial
i; residential, is it: Q Mngle Family Detached ❑ ConBoftnwnhame (single family attached) 0 Duplex
G Multifamily (apartment) ❑ Garage
r commercial, is it: Q Bank ❑ Bar ❑ Church ❑ HoteljMotal ❑ Medical afiee ❑ Ofnco ❑ Retail
Q Resi;gumRt ❑ Omer (explam)
Js this building So boars of age or more? Cl Yes ❑ No jfye$ yoreya- a6on
Y� ibis is fer=_ deaoritian perFni, tvhai:yaaz was drebullding mnsir•.re'�edY•
fr'priarca 197S, you WI need an ashest=aziasmantw srrbinit with this appricai7on.
DT pti0n or wor - r� • r T 2 —"i s fri>-t i aa•� rf if - r
US
*vlawnsprinlelerJbaddlowprevarfzw,musklist licensed plumber. V:irrtiimeAJC,mustlistlicensedelecsidan-
Suttcartrac era: L'•sYrhemmFc"rynsmeorOiyofFcCol6nslrc2nsa a
ecrid_n Plumber Neahadat. R007ar Pam- t35n Other
1 hereby acknwrn edge trek! have read this apptlmtion and state that the above information is complete and wrret_* l agree m
comply with all requirements cortialned heroin and ciW otdinancas and scale laves regulaling building consbudd0n. Y knowthato
permit ig Rd:valid untti is has been paid and issued•
r
Aoplican': JJtt �. !'•t.=.fi J '" Days. 1
PAnt, Nam i�+K �2tnni S 538aeture_.••