HomeMy WebLinkAbout4900 BOARDWALK DR - APPLICATIONS - 1/14/20201�yof Panning, DevelopMent, & TranspOt 6t1on Ser�rices' tins Community Development & Neighborhood Services
281 NoA College Avenue
Fort Cobra, Co BM74 Main: 970.416.274fl Fax 970.224.8134
OVER THE
This application is to be used to apply for ii
11 Demoliifion (interior non-structural) ❑ Bech
Cf Heating Unit .Q Lawn Sprinkler ❑ Mobile i
0 Ventilation 13 Water Heater ❑ Water line
manufacturer).
Complete all appricabje,111formation on the
Application #_ ZR l_1, 04 �1
Farotl�c�useo_n!}>'' U �
Sob Site Address (required)
Properly Owner Name
Applicant. Name
Contractor
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Contractor City of Ft. llins Sales Tax #
swestax number
Lis radbyaflto
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is this a residential or commercial project? Q
if residential, is it: ❑ Single Family Detachek
Multifamily (apartment
if commercial, is it: Bank 0 Bar ❑ Chum
❑ Restaurant E3 Othi
Is this building so years of age or more? E3
If this is for a dernolition psrmil� what year,
Description of work
Tif lawn.sprinkfer/bact¢low preventer, must list
5ubcontractnrs: UstML-cvmpanynameorC1
aedridan� Plumber
i hereby acknowledge that I have read this appii
i comply with all requirements contained herein By
permit is not valid until it has been paid an
I
l
ii� Name: �
ReHscntlat 2MUrd
OUNTER PERMITS ONLY
following permits only (check all that apply). ❑ Air Condi?foning
d Alteration (not service change) Q Gas Lighter ❑ Gas Log
me replacement ❑ Roofing 0 Sewer Line 17 Photo-vottaic
I Wood/Peliet Stove (must be EPA ce[iifled, provide make, model and
Incomplete applications will not be agcepted.
Date r 1�Jf
Value of consiru on
3 6c eo
City/State
Cray/State
_ .r.
City/State
Zip Phone
zip Phone
4 . 14
Zip Phone
;��F•fl"t•� 14t15 BLT� L� °'ta"r • r � �os�
Are you paying taxes here or by report? ❑ Here ❑ Report
Are you paying with your trust account? yes ❑ NO
p Condo/townhorne (single family attached) 13 Duplex
❑ Garage
1 [3 Ftotet/Motei ❑ Medical offm ❑ Office ❑ Retail
(explain) es ❑ No ryE* you may need to canWctfiesmdc Preser affon
is the buflding constructed?
Ef first-time A/c, must ust licensed electrician.
MechancW Roofer Other
tion and state that the above information is complete and correct. I agree to
city ordinances and state laws regulating building construction. I know that
issued.
I
7 U
Date- �