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HomeMy WebLinkAbout718 E Elizabeth St - Applications/Reroof - 06/01/2012 (2)May 29 12 11:43a Schroeder Roofing 970-669-3532 p.2 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 non-structural) ❑ Electrical Alteration (notservice change) ❑ Gas Lighter ❑ Gas Log ❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement 0 Roofing ❑ Sewer Line ❑ Photo -voltaic ❑ Ventilation ❑ Water Heater ❑ Water Line ❑ WoodiPellet Stove (must be EPA certified, provide make, model and manufacturer). Complete all applicable information on the application. Incomplete applications will not be accepted. Application # f) I 4� 0 3R Date For office use only Sob Site Address (required) Value of Construction (labor, materials, profit) 718 E Elizabeth St 39 Property Owner Name Address City/State Zip Phone Jason Quinn 718 E Elizabeth St Ft Collins 80524 581-7992 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 R. Collins Sales Tax # Are you paying taxes here or by report? 0 Here ❑ Report Sales tax numtexureouireartya#co"cmts. Are you paying with your trust account? 0 Yes ❑ No 41047 1 Is this a residential or commercial project? m If residential, is it: ❑ Single Family Detached ❑ Multifamily (apartment) Residential ❑ Commercial ❑ Condo/townhome (single family attached) ❑ Duplex ❑ 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 Ifyes, youmayneed to contact HistoricPreservabon If this is for a demolition permit, what year was the.building mnstructed? If prior to 1975, you will need an asbestois assessment to submit with this application. Description of work Remove existing roof install ail needed flashings, felt, shingles. *If lawn sprinlder/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician. Subcontractors: List the company name or Oty of Ft 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. Digilaly signed by Brian HI Applicant �t -, ' '. !` c „ Daca:2ou 03.22oS118:49 Print Name: Brian Hill Signature -08W pate 05/29112