HomeMy WebLinkAbout517 Smith St - Applications/Reroof - 11/30/2012Nov 28 12 02:11 p Schroeder Roofing Inc
970-66973532 PA
City of planning, Development & Transportation
281 N. College Ave P.O. Box 580
F6r1* Collins Fort Collins, CO 80524
Phone 970-416-2740 Fax 2246134
OVER-THE-COUNTER PERMITS ONLY
This application is to be used to apply for the following permits only (check all that apply). ❑ Air Conditioning
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement 0 Roofing ❑ Sewer Line ❑ Photo -voltaic
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and
manufacturer).
Complete all applicable information on the application. Incomplete applications will not be accepted.
Application # B I.D C)-i Date t d
For office use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
5171519 Smith St
2600.00
Property Owner Name Address
City/State Zip
Phone
Rick Bemum 5171519 Smith St
Ft Collins 80524
9703108145
Applicant Name Address
City/State Zip
Phone
Schroeder Roofing, Inc 9300 N Monroe Ave
Loveland, CO 80537
970 667-6777
Contractor Address
City/State Zip
Phone
Schroeder Roofing, Inc 1300 N Monroe Ave
Loveland, CO 80537
970-667-6777
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
0 Here ❑Report
Are you paying with your trust account?
0 Yes ❑ No
4104axnurnderesrequrrc�byapConbacrors
41047
Is this a residential or commercial project? 0 Residential ❑ Commercial
If residential, is it: 0 Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes ❑ No ffyes, you may need to rnntactHistoric Preseruadon
If this is for a demolition permit, what year was the building constructed?
rfprtor to 1975, you will need an asbestos assessment to submit with this appircanon.
Description of work _Remove existing roof install all needed flashings felt shingles
*If lawn sprinkler/backnow preventer, must list licensed plumber. If first-time A/c, must list licensed electrician.
Subcontractors: Ustthe mmpanynameorCity ofFtCo//insiice,7, >S
Electrician Plumber Mechanical
Roofer R-1408 ether
I hereby acknowledge that I have read this application and state that the above information is complete and cored. I agree to
comply with all requirements contained herein and city ordinances and state laws regulating building construction. I know that a
permit is not valid until it has been paid and issued.
Applicant:
Print Name; Jennifer Aldrich Slgnatur� A .!` �
Date 11-28-12