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HomeMy WebLinkAbout1644 S College Ave - Applications/Reroof - 07/10/2015Jun 29 1501:16p Schroeder Roofing Inc 970-669-3532 p.1 Fort Collins 11*1` 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 17 Lawn Sprinkler ❑ Mobile Home replacement © Roofing ❑ Sewer Line ❑ Photo -voltaic ❑ Ventilation ❑ Water Healer ❑ 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 # C31 S d SZ I Z Date / O - ( S For office use only Job Site Address (required) Value of struction (labor, materials, profit) 1644 S. College Ave. 360 Property Owner Name Address City/State Zip Phone Jeff Carlson 1644 S. College Ave. Ft Collins/CO 80526 970-599-2748 Applicant Name Address City/State Zip Phone Schroeder Roofing, Inc 1300 N Monroe Ave Loveland, GO 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? 17 Here ❑ Report Saks taxnumberisrequiredbya#contractors. Are you paying with your trust account? IZZI Yes ❑ No 41047 Is this a residential or commercial project? 0 Residential OCommercial 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/Motel ❑ Medical office ❑ Office ❑ Retail ❑ Restaurant ❑ Other (explain) Is this building 50 years of age or more? ❑ Yes ❑ No Ifyes, you may need to contact Historic Preservation If this is for a demolition permit, what year was the building constricted? If prior to 1975, you will need an asbestos assessment to submit with this applicab'on. of work Remove *If lawn sprinkleribacknow preveriter, must list licensed plumber. If first-time AIC, must list licensed electrician. Subcontractors. List the company name or City of Ft Collins license .0 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 arid state laws regulating building construction. I know that a permit is not valid until it has been paid and issued. Applicant: Print Name- Signature Date 06t29/2015