HomeMy WebLinkAbout900 SITKA ST - APPLICATIONS - 11/12/2014Nov•11. 2014 2:12PM ADVANCED ROOFING No•7871 P. 1
City of j j Pisnring, Development & i ra.^.sportation
F,~1. t Coth .,1s. 281 N. College Ave p.0. Box 580
�� /.-.tiror Collins, CO 60524
Phone 470-415 2740 Fax 224-61,34
OVER-THE-COUNTER PERMITS ONLY
This application is to be used to apply for the `ollowing perm?ts oniv (o.7eck ail. hat apply), ❑ Air Conditioning•
iJ bemeiitlon (interior ncr:-structureQ Q leCtriO&l' Alteration (riot service ChanCcl + ugs I ighter ❑ C-$S LCG
HealingUnit C. Lawn vp ,'9OCnng L $ewer _?rle ❑ Photo.
fVOIt6iC
Ventilation ❑ Water Heater C'Alaicr Line C W00d/i'ellet Stove (r;(•psi be ti?A c- 'ified, provide snake; mode! and
man&aCtUrer).
Complete all applicable information an the application. Incomplete apNiie2tions will nc, oe accepted,
Applicat;on it �l`i�a�`- Date- /%
For aMce use only
�rl- CPI Il Ks
Value o
r - ; ro� )
: 'R:c??Si:U c;n labor rnE- ipic a
S�
Properly Owner Nam, e Address City/StateRr'�e 1 Zp Sd(iZ/ Phone Stmp
77
c^�plicntName e Address Cy/Beata Up. Pnorte (�
Cont,CC.Or Lic r Address
Contractor City of r .Collins Sales Tax r
sz/es lax 17aMbx- is required by al/ c5r,& Fcbrs
aClDSlo
GLy/S��e Zip Phone
Are you paying'taxes hare or by report? ❑ Here G Report
Are you paying with your a uSt account? ❑ Yes ❑ i[lo .
Is this a residential or cammercal projer7 Residential EJ Comm. erC
_i esidentiai;'is it:. -"'Single"`drilly DE�cred"' ❑ Cand0/CCWnhC('ilE (Sii''CI@ family attaCled ' -• ❑Duplex
❑ Multifamily (apartment) 0 Garage.
If commerclai, is•it: ❑ 3ank ❑ Bar ❑ Church C7 HctelJhlctal E] crnce ❑•pace El Retail
M Resiaurant ❑ ott)er (explain)
is this..5uilding 50 years of age or more? ❑ yes ❑ No L`y.a5, you may aevd'r'o cor act His Inc R'eservec�on
If this Is for a demolition permit, what year was the building consaucted?
Ypi:'or to 1975, you Wyly need ?n asbestos assessment a submit wish t~715 application.
Description of worn;
*If lawn spenkler/bac.Vlow privent=r, mush llS licensed plumber, If ilrst•dme AIC, I!Si iicerdc-d elec" ICIc -
Succnntracters;'4kt_bjecompany nzneor, Clt;ly
EIEC `iidan Plumber M'1 aniLl Roof?r
Other
I'here6y 26',iowlzd92 uSaCi have is_d this 2caiicatiCn end ; to Witt Gy2 above Infer:,,aton is tampictesnd correct I zgree to
comply with. all requirements conaine-e( hereir, and city ordinances and s`te !aws ragu!atina building eonst-ucdon. I know that a
permit is net valid until it has been paid and issued,
Applicant: � ,-,
Print Nane: � �}�_ 5ignaiur2 i Q nata —�