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HomeMy WebLinkAbout4900 BOARDWALK DR - APPLICATIONS - 11/11/2016Nov 21 16 01:50a Ellmann Service Cc 9702233324 p.5 Qi Planning, Development &TCtansport�ion- - •'��'�Y. Collins 281 N. College Ave .-P.O. Box 584 Fart Coping, CO 80524 Phone 970-116-274D Fax 224-6134 OWK-THE-COUNTER PERMITS ONLY •. e This application Is to he used to apply for the following permits only (check all that apply). 0 Air Conditioning 0 Demolition (Interior coon -structural) U Electrical Alteration (not service change) 0 Gas Ughter 0 Geis Log .1 0 Heating Untt 0 Lawn Sprinkler L7.MobVe Home replacement 0 Roofing 0 Sewer Una • ❑ Photo -voltaic 0-Ventilatior Hater Heater ❑ Water Line 0 WoodlPellet Stove (must be EPA certified, provide make, morsel and manufacturer). _ Complete all applicable kfqgmatlon on the application. Incomplete applications will) not be accepted. Xp- I �aApplication #� J Date Forca0lm Lm only // 2! r A. Sob Site Address ftWfra o Value of Construction (labor, materials, profit) aj�� Address j3rJ15 . Cityj5tate VtV- - ip Phont7 o . 0 f wig o `13i v 1 t L n2. Applicant Name Address Cil stam Zip Phone Contractor Uc Address city/stale 2rp Phone !iS^i Lil./r• ° ��C-•L !�� } /� � f�R�!'c S/'9//9�Z .�iT/tJIL .»'7i`'t Contractor Caty of FL Collins Sales Tax # 3kz2v,J-- Are you paying takes here or by report? 0 Here Cirkepart Saks ternumberisrequh&byallcontraciam Are you paying with your trust account/ K'Yes 0 No Is this a residential or commercial project? 071keddentfal Cl Commercial If residential, is is OSingle Family Detached 0 Condoltownhome.(single family attached) 0 Duplex 13 Multifamily (apartment) © Garage lFcamrrmeraal, Is It, 0 Bank 0 Bar 0 Church 0 HotSel/Motal D Medical office 0 Offim Cl Retail D Ra courant t] Other (explain) Is this building 50 years of age or more? © Yes ©No Ifye!� ynu mayneedd to coma tH%SaxicPraservabian If this is for a demolition permit, what year was the building constructed? Ifanarto 1975! ynw'wW nwd an asbestasa ntiosubmfi wa t'tilsAA0r1w bn De=1006 of work *If lawn sprinkledbaddiow preventer, must trst licensed plumber. If f rst- Me A/C, must list licensed eleLlrk ian. S u bco nt ra c Wrm L & Me comp anyrmmeor02Ya0tC'alSWrcrr2se. ' Elee�fdan plumber 1 m erhanicai Roofer Other, I hereby acknowledge that i have read this application and state that the above Information is complete and correct I agree to comply with all requirements contained herein and city ordinances and state lativs regulating building construction. I know that; a permit is not valid until it has been paid and Issued. prat Dame: -- cote l f�