HomeMy WebLinkAbout620 HILLVIEW CT - APPLICATIONS - 4/10/2015 (2)Mar,31, 2015 4:53PM ADVANCED ROOFING No,8196 P. 1
City! of
Pfanaisgr Devefo;,ment & T'ransportatfon
Flir t Co
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81 N, Collece Bve P,C. Sox 5a0
Fort Collin=:, CO 8-0524
Phone 970-4105-2740 F Gz 224-51 4
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R-THE-€COUNTER PERMIT'S ONLY
This application !s to be Used
to app{y for the fclloaring permits only (check ell thai: aPplv), r_ Air Cond*;oninc
i bamoiition (interior .non^st,
c:! ral) --, 21ect7ical ARaration (nat service chance) Gas Lighter _ Gas Lcc
❑ Heating Unit = Lawn Sp+
nKler C mcblle Home repfacemnt Q+D Roo-ing Cl 8e'rrer ine F-1 Phcto-voltaic
C. i
Ventilation ^/ater r ieat
r L7 Maier Line 'Alood/Psilet Stove (;, ust be EPA ce,^if;ec , provide +mEke+ mode( and
manulacturer).
Complete all applica {e mic
I
rmation on the application, Inoor*,•,p{e;a applications will nct'na ac-- T
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Property Owner Name
Address Cif'/cat )i k.S Z'sp 905`a hc 970
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Addrass ctY/stat=_ Zip. Phone
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Contractor UC =
Address City/Si-aL= dip Phone
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Loh SI�'iL JJ
Contractor City or" �c. Collins Sales
Tax Are you paying txes here or by -,apert? r] Hare ❑ Repo+L
52/es�xnumcerisre?ulre bye/I co
a�dSLO
2ccors. Are you paying wit` your U-Lst BccounL? 0 Yes Cl No ,
Is ttils a rasidentlal or Comnerd l project ? )(R-sid=ntlal q Con, merce!
it, residentat, ;s it; 5inglz = r,,Uy Deczcned. ❑ Candb/townt cra (=ln;i2 fzrn+{lv atiic ed) C Du ex
C] Multi -'am ( e
y (apa:�-n_nt) fig�garage
If comrerdai, is t: q 32nk Sar ❑Church El He-,evmotej q Medic! ct ;cs L-"C;;;ca ❑ Re7
C! Restaurant El 0*4her (E)plain) fj lz v J—
Is unls..buildlrg So years of .age r more? u yes a No i`yes, you mayneey _� Con- jL' stoic Prererva7on U
If this :s ;or a damolitiorr perm! , what year Vras th= bu{Icing Cpnsu'UC 2d?
I; pnbr tb 1975, }au roil need =n 195bastus as=zssnEnr to submit wrut;�/s Epp/icaricn.
pescript;oncfwork .R% QC-S> t eSPDSL ni 1 c ti v1/�_ ":!=c
*TTf lawn, sprit ker/backrlow privent rilusi list IIC� s L' Cer, if F r St-t]�e f C c+ " , • m / , m < <;� icensed s,ect. :Can.
G� F
SuecontraCtocs: is the c�n�r; nerve or GPy cr F Cq//its licerzs: ,�" ,v, f�,�
seCJiGzn Flune Nectiniczl ' •
Phereby ack,7owledyd that I have rc-d this 2cPllczScn and State LSEt the cbove inforr,-,a on is of plcte and correct, I cc.fee i0
COfilrly vllu`t,all r?SUlr e;'�u Q-nt2ir ed hereir, Pnd City of inanG9s and stole 12w5 r.yLlla-L i Q bUil-&ing Cp; ��r�_C_ioil I knew they a
permit is net valid until it has been paid and issued,
Applicant:
Print Name: Sr n
9 at rz Dace