HomeMy WebLinkAbout668 JUSTICE DR - APPLICATIONS - 7/22/2015From Affordable Roofing Inc 1.970.207.0289 Tue Jul 21 16:30:48 2015 MDT Page 2 of 2
t.<vAManning, beveioprnenr & e ransporiazion
,., �? 63
AA a 0 a 28 N. College ;Ave P.O. Box 580
E �a oI�>3;1t ks Fort Collins, CO 80524
�� m "�• Phone 970- 16-27;0 Fax 2.?9-613r;
O `ER- ������ 415E PER TI SS VN�
his application is to be used to apply for the following permits only (check all that apply), C+ Air Conditioning
13 Demolhion (interior r,on-structural) C Electfical Alteration (noi service change) C1 Gas Lighter O Gas Lcr; v
- Hearing �,irn_ Unit awn Sprinkler ❑ 'Vloblie Nome ,eplacsinent u Roofing u Sewar Lire J Photo•toltaic i_.' Entilc'tion F2 lrV ;tar i-ieet`r l7 %Alc er Lins C'KocdrPeilet S"icVU" (IiiUst he EPA iwariified, provide mak8, mad21 =nd
Manufacturer).
Complete Ball applicable iitfiormation on the application. Incomplete applications will roi: t,e accept
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r .4 Value of Construction. (labor, materials roni:
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t::n-1L577heC iC: c;L[IlrL�j�•�Ii ConbaeFcr:. ire YOU paying With your Cf.USt aCCGUnt! l7 Yes [ No
te7ii dendal or carranerdai
:oc_c? 'Res e.n—.i.=i L `resi is Orr-Me—rC13l
it. Single gamily Detached
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1: CO, dOAD'Innome (single family attached) ❑ Duplex
t+iulb --�miiy (apartment) C Garage
!'r commercial, is i't: M Bank ❑ San ❑ Church n I•lOJ/Motel ❑ t cclica- oifl :e r.. C•" i f- Oiii c _1 Retail
:=i Reetaurant L Qtl'Er (e?pidil`.)
i:s _his ou:Idinci EQ ,tears a," age or more? u Yes ❑ No .Ir • uma `nf�
t'i-iG .:':; yes, d r d vroncati Historic Prser�afio.7
._ r a eernolitlon permit, what pear r,as the buiidin9 contruci�d?
%.1; ' wiii raed cr asbw.. scSS�S�� ear Q7 SIICUTii :V.'JJ7 1?�71520p/.'Ca-e70n. ._......--__--�
UP
IMM, So '11kieribacia:ow preVenter. MUSThis lic2n� Plumber_ rf firi-:ime /C, must lir'.licens`d electrician.
c' ixcorstrector::-isP7eca.roanyname orCi:}<ofFr.Co9irsfice.�se=
--_ Fiumba `, iv _ ra,;ch;ni:ai ^• � �•5cl ,
other
Wit'=+7 BCknClro9Edt]2 ihaC _ 1'iaVe^ read thlS oppficetion and 6t3tC That the abc%re infaralation is compiate Pond �prC,-C(. atjCce :�f
all CCgUIi t'm`?rlt5 COnie31n2tl hri'2jn and city ordinances and state iBWs requistinCj bUildinCJ consttrUCCIOn. _T know that"a
actin;i ?s noivatld trhiit is has bean paid and issued,
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7riat Nam,
Signatur`,,_
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