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HomeMy WebLinkAbout4900 BOARDWALK DR - APPLICATIONS - 9/18/2017Of B nkS Owdopmwit & ThanspwUltion Collins fort Cdl�t'A 80524e Ave .0 - 580 Phone 970-416-2740 Fax 224-604 OVER-THE-COUNTER PERMITS ONLY application Is to be used to apply for the foilowlrM pmnits only (check; all that apply). Cl Air Conditioning imolition (Interior non-structuml)i ❑ Electrical Atteration (not service change) ❑ Gas lighter ❑ Gas Log gating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement ❑ Roofing ❑ Sewer line ❑ Photo -voltaic Al -Water Heater ❑ Water Lure ❑ WoodlPetlet Store (must be EPA certified. provide make, model and all applicable iMormatlan on the appiiaafion. Incomplete applications will not be accepted. # 6 11 D UZ (91 Date - q1/ :9l/7 For alke ase a* ? site Address (fegti ed) Vahn of Consb uctlon (labor, fflaterfals, profit) t n bm - �-A-- -30 /,-3 Owner O&Mr dress I2.J55 . �y/S ate Z4AV4 t Zp Phon O - te! 1. o t d. 22Z 3Zr - 900ntName Address CILY/State ZIP 13110331Z. ot. 8052 C4ntractor i9//M Mr Address QtY/state ap OW&zz 33t JP E0Vi� 11q ?4(AE LACE A '� .tics CD 44 CutyofFt.CoiMsSalesTax#�Z0S Areyou paying taxes here or by report? ❑Here ,l°4. Wrt 1! ftnbarls bYaaaww Are You paying with .your trust amount? .kYes ❑ No :nw Is this a residential or commercial project? ,ELResklen ial 0 Commercial If residentlak is It: 364.W4e. Family Detached ❑ Condojeownimme (single family atmc ied) 17 Duplex O MuitlfamiPf (apartment) L] Garage If cmwnerdal, is it: O tank U Bar 11 Church ❑ HoteVMotel ❑ Medical office O Office Zi Rean © Restaurant ❑ Other (Main) Is this budding 50 years of age or more? ❑ Yes O No ffM youmeynaed m cvalaethltraar>i Amwvao3w If is is for a demolition permit, what year was the building constructed? . to 1973, you xW need an asbestw a-gmwwtt M m&nft wZft dW app6tabrgn of work lawn sprinlder/baditw pmwrrter, must rest licensed piumlber_ If first-time A/C, roust list licensed ele*idan. l istthe crar4oanynww orOfyofP1 CaAw ka7se # Plumber t lanical Roofer 0dW r 3doreuik4ge that I have read this applicaWn and state that the above irdoraralim is complete and correct I agree to with all requiremen e 1 la red herein and city ordinances and state laws regulating building fin. I loww that a . Is not valid until It has been paid and issued. AIA t,'d 9 Lb0-Z9ti-0L6 Luodwoo Bowes uuewlle d0£:90'L L ZO lo0