HomeMy WebLinkAbout3355 Oregon Trl - Applications/Reroof - 04/30/2018Cit
F6ryt Collins
of
Planning, Development & Transportation
281 N College Ave P 0 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) CI Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement KRoafing ❑ Sewer Line b Pl oto 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 # VOM 51 � I Date
For office use only
Job Site Address (Ulred)
Value of Construction (labor materials profit)
3355 Oregon Trail
$7529 15
Property Owner Name Address
City/State Zip
Phone
Jaime Yebra 3355 Oregon Trail
Ft Hollins CO 80526
303 887 3134
Applicant Name Address
City/State Zip
Prone
Betty Sanchez 614 5th Ave
Greeley CO 80631
970 395 0406
Contractor Address
City/State Zip
Phone
Bob Behrercls Roofing LLC 614 5th Ave
Greeley CO 80631
970 395 0406
Contractor City of Ft. Collins Sales Tax I`
Are you paying taxes here or by report?
IKHere ❑ Report:
See% t-1z 111nrt er IN WIVIrfd bV ell cvrit acim"
Are you raying With your trust: account?
IXYes ❑ No
41034
Is this a residential or commercial project? R Residential ❑ Commercial
It residential, Is It X Single Family Detached ❑ Condo/townhome (single family attached) 0 Duplex
0 Multifamily (apartment) 0 Garage (Shed)
If commercial is it ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail
❑ Restaurant ❑ Other (explain)
Is this building 5o years of age or more? ❑ Yes CKNo 1f yes you may need to contact Hlstcttc Preservation
If this Is or a demolition permit what year was the building constructed?
1f pnor to 1975 you w111 need an asbestos assessment to submit ivith this application
Description of work Tear off 1 layer and install synthetic felt Install ice&water shield in valleys Install edge metal at rakes&'
eaves install Ciakridpe Woodland Path shingles 26 'il3sq 2 story
*If lawn sprinkler/b-ickflow preventer must list licensed plumber If first We A/C must list licensed electrician
Subcontractors Ust the company name or City of Ft Collins license #
Electrician Plumber Mechanical Roofer R 1772 Other
I hereby acknowl-dge 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 Betzy Sanchez Signature
Date 415/2018