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HomeMy WebLinkAbout4900 BOARDWALK DR - APPLICATIONS - 10/24/2018-✓7-4,�ac• ";/�3a_-,,,��jsrs-v-!;' tfi�s T.'1'ry! �?�do do Services �`u t 'Ls lui Comr win ijr Development C'-' neighborhood Services 281 hart! College Avanue -o" Collins. CO 86528 Niain: 97G 4t627+':g F23c 970.224.6134 OVER-TI H CO'UNI1ER PERMT1S ONTLY t liis application is to be used to apply for the following perm its only (check all that apply). 0 Air Conditioning 0 Demolition (interior non-siruciural) 0 Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log 0 Heating Unit ❑ Lawn Sprinkler 0 Mobile Home replacement II Roofing ❑ Sewer Line ❑ Photo-voliaic ❑ Ventilation ❑ Water Heater Afater Line ❑ Wood/Pellet Stove (must be EPA cerned, provide make: model and manufacturer). . Complete all applicable information on the application. Incomplete applications will not be accepted. Application 3 01 For of Tca use on/y Date t•2td' I5 � Site Address (required) i'al€re ofO��str�ei:s©n (labor, materials. profit) ': � O� Property Owner Name Address CityJState Zip Phone M is 90 . F c. CO 805TA LAM.- -1oq Applicant Name Address City/State Zip Phone Contractor `'� Address City/State e Zip Phone Contractor City of Ft. Coo ins Sales Tax = M0e 9 Are you paying taxes here or by report? 0 Here ❑ Report Sales tax number, is required b,, a0 mninactors Are you paying with your trust accouna No s this a residential or commercial project? Vkesiderrtlal ❑ Commercial ff residential, is it: CI Single Family Detacfiea ❑ Condo/townhome (single family attached) Q Duplex Multifamily (apartment) ❑ Garage If commercial, is it: Cl Bank ❑ Bar ❑ Church ©•HotelJMotel ❑ Medical office ❑ Office ❑ Retail ❑ Restaurant ❑ Other (explain) is this building 5e .jears of age or more? o Yes ❑ Na !Fyes, you may need to contactHlstorlc Preservation If this Is for a se=?Dii ion peTi:lt, what year wags the building constructed? j Description of work 0. O Ii -T lawn sprinklerjbackilow preventer, must list licensed. plumber. If f rst=tine AIC, must list licea yes? e`e iS C5�5?. 5ubcon;:raceers: List -the company namq or Ci�y ofFr Colens license = Electridan Plunber Mechanical Roofer Other I hereby acknowledge that I have read this application and sate that the above information is complete and correc`u I agree to comply'.vit'n all requirements contained herein and city ordinances and sate laws regulating building consrruction. 3 know that a j uerniit :s not valid u nt!f ithas been paid and issued. Mr-i'iane: M) CA L (A & Signat-UreA&'/' i Date- . I U ' 7- �i I 2n%�n d L IF.C•At<