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HomeMy WebLinkAbout4332 WESTBROOKE DR - APPLICATIONS - 8/29/2016Ckj/ o , 1)ewA voa mtB Uportedon Fort Collins bC-ms.CO80524 Phone 970-416-2740'. Fax- 224-61M OVEWTHE-COUNTER PERMITS ONLY 'his q*M=Wm is to tyre rimed to apply fw th. fonowfng pemits only (dn& an that q*il .13 Air C onditioning 0 DenxMpn (interior non-etrucb=Q D EleCWW Alteration (not service chaW) D toss Lighter 0 Qas Log D Heading Unit ❑'Lawn Sp Wder O Motes Hone r+epl wmnm t M Roofing E3 Sewer Line _O Rwbo v+oikk ❑ Venbi<atlon 0 Water Heater O Water Line Cl Wood/PeM Stove (must be EPA ceffied, provide make, model and mamba treO. Compk%all applicable hdonraidon on do applicadon. hmmpleft dons win not be gybed. APPIICBVW Date 8 /a 9 rara9;foeraea* 39b � �egvOW - .3kM_ Of Vv�la�a�iff"YY�� l°a'^Ar Prom) 11333.) • wgsrQ oo E 906.16 $ ) .8, 5.d?o Properly Owner Name. Address City/Sfiabe T.rp Phone .DjqU`,9 iaJ ' ©o Via: 4 �� c� .`�0. 2 10 - ;75 Applicant Name .Address (3ty/State ZIP Phone 0. 0J.0 A6.4 ,2cws 2.3 =j)_V"JadxJ AD04L c.0 +''r Cont ador tic # Address CI y/5tate ` Zip -one GEDs9/z C'eaSy- �, R-1?] h 4. 2 CMUac6or Crty of FL Wrens Sales Tax # Are you paying t w= here or by report? ® Here O Report S s&cmmnwisagwaifbyas9 aywaam Am you paying -with your but a000unt? 0 Yes L7 No Is this a residential or commercial project? 13 ReddenW 17 Commerdal V residential, is it+ ® Single Fan* Detached E3 Co bito n%me (single fanY aludwo 13 Dtqft +� 13 Multjiamfly (WaMnent) D Garage if oorrrnmdai, is t: E3 Bank 13 Bar 13 Church 13 Habel/Motel 13 Meckal ofiioe 13 Ofiiae : 0 Retail E3 Redaurant 13 other (explain) is this buudfng So vmm at age or more? 0 Yes Is No Dfyes, you maYn8aed fa cVH&K 'JtBsmafcPles�vaa0r'► if this is for a deamoGtion permit; what year was the bull &V aorstr x bed? Yprfor to1975,)vya0need aaaOesWsamemMWttoa*nt*I&V&4W f 3tM : *If lawn swpb /badcfiaw preventer, must list kensed plumber.. If first-time AjC; must list licensed elecbridwL Srr0-wd:asbww r.ARZA eel r � R aarfoiG I hereby adurawfedge chat I have read tiie qV abm and state thatthe abMM Kwaauon IS eonplebe and rn on' I agree to comply with all r+equff emads eonmined herein and city odlnances and state laws reguafing bu1ft cumbucWL I iurorrr that a peerrrN its not va6d untV It iw been paid amd blued. s Appikeft Print' Nsree- DAumuP PEA;Qnut.�'I�4�' Si Erne � ���:Dew 4 ��