HomeMy WebLinkAbout508 KIM DR - APPLICATIONS - 8/9/2011Aug 04 11 05:39p Schroeder Roofing
970-669-3532 p.1
of
Fotrt 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 (not service change) ❑ Gas Lighter ❑ Gas Log
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement 0 Roofing ❑ 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 # 11 (7 ��Cp'1 Date / 22id
For office use only
lob Site Address free lred)
Value of Construction (labor, materials, profit)
508Kim Dr
2300
Property Owner Name Address
City/State Zip
Phone
Richard Rowe 508 Kim Dr
Ft Collins 80525
303-902-6135
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 is requrned by aft contraclivy.
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 may need to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
If prior to 1975, you wilt need an asbestos assessment to submit with this application.
Description of work Remove existing roof, install all needed flashings, felt, shingles.
*If lawn sprinkleribackffow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List the company name orClty cf 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.
e,! Digitally sigr d by Bran Mill
Applicant: Date: 2011.08.0416:5702
Print Name: Brian Hill Signature .06,00 Date 8f4/11