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HomeMy WebLinkAbout4906 SMALLWOOD CT - APPLICATIONS - 9/15/2011Sep 1311 05:09p Schroeder Roofing 970-669-3532 p.3 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 (not service change) ❑ Gas Lighter ❑ Gas Log ❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement m 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 # 0 (1 0 4q � Date 11151, 1 � `I • �>L For office, use only Job Site Address (required) Value of Construction (labor, materials, profit) 4906 Smallwood Court 3433.00 Property Owner Name Address . City/State Zip Phone Anders, Kim & Kurt 4906 Smallwood Court Ft. Collins, CO 80528-6565 970-223-4563 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 israquimdbyall contractors Are you paying with your trust account? m Yes ❑ NO 41047 Is this a residential or commercial project? m Residential ❑ Commercial If residential, is it: ❑ 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 11 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 will need an asbestos assessment to submit with this application. Description of work Remove existing roof, install all needed flashings felt shingles. *If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician. Subcontractors: List the company name or Cityof Ft Collins license # Electrician Plumber Mechanical Roofer R-1408 Other 1 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. � Digilavy signed by 9Aat Hil Applicant: % ql� C C{ Dale 2oi1.09.1315:22a9 Print Name: Brian Hill signature -0607 I Date 9/13/11