HomeMy WebLinkAbout1439 WAKEROBIN CT - APPLICATIONS - 8/29/2017Aug 29 17, 03:14p RMRG
9702241211 p.1
PlazmbW Development & TraaaWorbition
281 N. Collage Ave P-O. Box s80
Fort Collins, oo 80524
Phone 970-416-2740 Fax 22+6134
OVER=THE-COUNTER PERMS ONLY
Tt Is application is to be Used to Wly for Ow following permitrs only (check ad that appbJ. ❑ Air Conditioning
❑ Demolition (hdaflor non-structural) ❑ Electrical Alteration (not service c'ange) ❑ Gas lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement A11:900fmg ❑ Sewer Line ❑ Photo•voltak:
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
m ufackner).
Cc Glebe all applicable hdonnatton on the application. 111001111011010 applications will not be accepted
A4pffcadon # k J 1 —� V SI I Date _ �31
farofike tais,a*
Ske Address (r dj val l of C-7onssbuction. pabor, mates. Profit)
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Owner Name Address City/State Zip Phone
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Icant Nwne Address aty/State ZIP phone
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3 Address
w.o:u-•aE1ec:� aY/S'tate Zip phone4�7'o
146
t* of PL Coffhts Safes Tax *'f f 3 *(e Are you payhrg taxes here or by report? ❑ Here It Report
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tarmanb"MW~b1af , FM amrs Are You paying with your bust a000unt? $ Yes ❑ No
Is I ils a residential or m merdal project? fid �Siderrtial 0 Commerdal
If b is 0Single Famiry Detached ❑ Condo/6ownhome (single family attached) CI Duplex
❑ MuRrferMy (apartment) ❑ Garage
If mmeraai, Is it: ❑ Bank O Bar ❑ Chung O FloWMotel ❑ medical offioe f] Office ❑ Retail
Restaurant a Other (explain)
IS is 711ding 50 years of age or more? O Yes P'No ffyt� you may need to acntact;T5—& f vatp�
If or a derraoBtiM pernb% what year was the building consbvc ed?
o19;2,yuxt►rifneedartasbastwasaeswwnttos wide#0aAmRaftm
*If
IC
gxftdda/baddlow prevwMrr, must Est QaaLsed pdmrber. If first -One A/C, must ibt ketrsed electridan.
LFstfhrl ccvttpanyneme or myCfft Caeff ATM a?
Pk"n Roofer Other
V admowledge that I have read this appif , 'in and slate that the above I rformation is corrplebe and cornecL I agree to
vft all requirerrrerrts eontahed herein and dqr ordinances and state laws regulating budding fin. I Inrow that a
Is not vafld malt It bile been paid and Issued.
Mwb
Name: Ck