HomeMy WebLinkAbout5117 Greenway Dr - Applications/Reroof - 07/29/2014Jul 28 14 02:31 p Schroeder Roofing Inc
970-669-3532 PA
of
Fort Cottins
Planning, Development & Transportation
281 N. College Ave P.O. Box 580
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-6134
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 # N4pL4c[G( Date -7
For oflfce use only
Sob Site Address (required)
Value of Construction (labor, materials, profit)
5117 Greenway Dr
3033.00
Property Owner Name Address
Gty/State Zip
Phone
Nichote Rafos 5117 Greenway Dr
Fort Collins 80525
970-222-6243
Applicant Name Address
City/State Zip
Phone
Schroeder Roofing, Inc 1300 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 Gty of FL Collins Sales Tax #
Are you paying taxes here or by report?
0 Here ❑ Report
Sales tax number tsrequardbyaprnno-acft%
Are you paying with your trust account?
0 Yes ❑ No
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 (e)plain)
Is this building 50 years of age or more? ❑ Yes ❑ No If yes, you may need tv contact Historic Presewtion
If this is for a demolition permit, what year was the building constructed?
If pr/or to 1975, you will need an asbestos assessment to submit with this ap#ication.
Description of work
install all needed
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List me company name or City of R Collins license ,C ,
Electrician Plumber Mechanical Roofer R-1408 Other
I hereby acknowledge that I have read this application and state that the above information is complete and correct. 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.
C
Applicant.
Print Name: Jennifer Aldrich Sig twt ire
pate 712812014