HomeMy WebLinkAbout4130 SUNSTONE DR - APPLICATIONS - 4/23/2015From Affordable Roofing Inc 1.970.207.0289 Thu Apr 23 16:33:11 2015 MDT Page 2 of 2
any. of
'FortCoWns
Planning,'DeVelopment & Transoorra=icn
281 N. College Ave .P.O. Box 58r,
For Collins, CO 8052/
Phone 970-416-2750 Fax 221-0613=
This application is to be used to apply for -the following permits only (check all that apply). 0 Air Conditioning
❑ 7ernolitiah .(interior non-dructural) ❑ Elecmcal Alteration (not service change) 7 Gas Lighter D Gas Loa
❑ Heaiing Unit ❑ Lawn Sprinkler ❑Mobile Home replacement G Roofing Cl Sewer Une ❑ photo -voltaic
❑ Venvle ion 0 Water Heater ❑. WatYrUn=_ Cl Wood/Pellet. Stove (must be EPA cerld led, provide make, model and
manufacturer).
Complete all applicable in;ortthation on the application, Incomplete applications will not be accepted
Application # 150 o?143 Date
For once usz only
Sob: Site Address (ragwl2d)
4i9JA7 (S} -ton Dr,
_ aiue of Construction 0abor, materials, profit)
j P, ciperty Owner Name
Address
CIy/state Zip
Phone
' I Plican'LName
i1 �� 1��
Address
City/Sian Zip
Phone q�tj q
;VIAa
l�t
L� .TipLA PLC iSU5A,.5
90-7-600
ContiaCWT )
I
I
Address
Cx}, Sian 2m.
Phone t
I
1 Contractor City of Fi Collins Sales Tax
r_, rnun, rs-rlsr�quircdbyzll rrrrrozcbr__
I -
Are you -paying with your trust account? ' Yes
❑ No
j Is this a rsidenaoi or commercial project? 9511esidenual .0 Commercial
ii residential, is IC 2915fngle Family Detached ❑. Condormwnhome (single family attach
eo) ❑Duplex
' ❑1 Multifamily (apart ei t) ❑ Garage
±= �mmeFCNo , is kc. L7 Sank Bar ❑ Church ❑ Hotel/Motel ❑. Medical office ❑ Office C7 RetBil
I Ell Pstaurst ❑Otter(expfain)
I Is this building 8d years of, age or more? r7 Yes i7 No L yes, you maynead to etvniarihts(orlcpr�senraGon
I if this is for a demolition Dernit, what year was the building canstruCted?
i it pror in 197$. YOU 9W11.need an asbestos as�ma-at to subnii Wiffi biis anp/lcoe7on. f
r
Description of Work
*iP lawn _rinkler/backiioty pr2venter, must list frcensed plumber. If fif �me AIC, must.b& licensed electrician. -
eubcoa.rctors: Ust MzmmasnynameoraWoPFrCaIllns/icansa
Ff.Ecldden Plunbu m:.cnanrml Road -) g 5 of other --
I hereby 5-cknovIdedge Uoi: r have read this application and state that the above inrormadon is complete and conza 1 agree to .
comply avith all raquirUnents.contained herein and dq, ordinances and state taws regulating bulding =,LWuctlon. g knowthat e
Edcrmit is not; valid until r has been paid and issued.
ppliMIT:
nrint tdame: rrl t �J �a��i4..r.5 _—Signature