HomeMy WebLinkAbout701 Rochelle Cir - Applications/Reroof - 08/19/201408/19/2014 07:59 9703539774
noof
r t Collins
INDEPEDENT ROOFING I
PAGE 01
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) 0 Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement EN Roofing ❑ Sewer Line O Photo -voltaic
❑ Ventilation ❑ Water Heater 17 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 # &0( 3970 Date 8-19-2014
ForFor f use only
Job Site Address (repulred)
Value of Construction (labor, materials, profit)
701 Rochelle Circle
$11,500.00 38 W.
2-stoly
Property Owner Name Address
City/State Zip
Phone
Mark Giese ha an Same
Ft. Collins 80526
970-223-7553
Applicant Name Address •
City/State Zip
Phone
Tim Kramer 405 22nd St., Greeley, CO 80631
970-398-1389
Contractor Address
City/State Zip
Phone
Inde a ent Roofin Inc. Same
970-353-1389
Contractor City of Ft Collins Sales Tax #
Are you paying taxes here or by report?
® Here ❑ Report
Sales rarnumber/srequireebyallConbudes
Are you paying with your trust account?
>8 Yes ❑ No
Is this a residential or commercial project? Ixi Residential ❑ Commercial
If residential, is it: M Single Family Detached ❑ Condo/townhome (single family attached) ❑ Duplex
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ church ❑ Hotel/Mobel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 5O years of age or more? ❑ Yes EXNo If yes, you may need to contact mbric Pmwrmuon
If this Is for a demolition permit, what year was the building constructed?
Ifpnor to I97S, you W//need an asbestos mwmment to subm/t• WO this applimbon.
Description of work Tear off to deck, install drip edge, ice guard at eaves, 30 lb. felt, valley tin,
----pipe jacks roof vents, and OCF Duration Storm class 4 Tru Def. shingles
✓?ea�in9r C'w= 5 i5twhiere
*If lawn sprinkler/backflow preventer, must list licensed plumber. If firs"me A/C, must list licensed electrician.
Subcontractors, L& ffie companyname or City of Ft Col/!ns l/csim .0
Mectridan Plumber. Mechanlol Roofer R-294 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.
Applicant.
Print Name: Tim Kremer Signature Sim icuunes
Date 7/28/14