HomeMy WebLinkAbout219 E Plum St - Applications/Reroof - 05/21/2012May 21 12 09:11 a Schroeder Roofing
970-669-3532 p.4
Fort Collins
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 nonstructural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement 0 Roofing 0 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 ✓MO Date
For offrce use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
219 E Plum St
28
Property Owner Name Address
City/State Zip
Phone
Janet Scott PO BOX 271336
Ft Collins/C0 80527
69D-5507
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 City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
0 Here ❑ Report
Sales tax number isryuiredbyall conb3ci!c.s.
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 (explain)
Is this building 50 years of age or more? ❑ Yes ❑ No If yes, you mayneed to confactHBWric Preservation
If this is for a demolition permit, what year was the budding constructed?
Ifpnor to 1975, you will need an asbestas assessment to submit w1M das app/z'abon.
Description of work Remove existing roof, install all needed flashings felt, shingles.
*If lawn sprinkler/backfiow preverl must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: Ust the company name or City oFFt Collins license # ,
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.
of tally signed by Brian Hill
Applicant: rr Date.2L12.0=D9t18:49
Print Name: Brian Hill Signature 46'00, Date 05-21-12