HomeMy WebLinkAbout3858 CENTURY DR - APPLICATIONS - 3/13/2014Mar 031410:19a Schroeder Roofing Inc
970-669-3532 PA
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 -COULTER PERMITS
This application is to be used to apply for the following permits only (check all that a
❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas
❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement 0 Roofing ❑ Sewer Li
❑ Ventilation ❑ Water Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certifie
manufacturer).
Complete all applicable information on the application. Incomplete applications will
Application # 51 q 0/ 2 Y (- Date
For office use only
ILY
My). ❑ Air Conditioning
ahter ❑ Gas Log
❑ Photo -voltaic
provide make, model and
be accepted.
Sob Site Address (required)
Value of Construction (labor,
materials, profit)
3858 Century Dr
2200.00
Property Owner Name Address
City/State ZilP
Phone
Paul Thayer 3858 Century Dr
Ft collins/ CO 80526
420-7789
Applicant Name Address
City/State
Phone
Schroeder Roofing, Inc 1300 N Monroe Ave
Loveland, CO 8017
970-667-6777
Contractor Address
City/State Zi�
Phone
Schroeder Roofing, Inc 1300 N Monroe Ave
Loveland, CO 805p7
970-667-6777
Contractor City of Ft. Collins Sales Tax 4
Are you paying taxes here or by report?
0 Here ❑ Report
Sales tax number& required by a# contractors.
Are you paying with your trust account?
0Yes ❑No
41047
Is this a residential or commercial project? 0 Residential ❑ Commercial
If residential, is it: m Single Family Detached ❑ Condo/townhome (single family attach(
❑ Multifamily (apartment) ❑ Garage
If commercial, is it: ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Off.
❑ Restaurant ❑ Other (explain)
Is this building 50 years of age or more? ❑ Yes ❑ No If yes, you may need to contact
If this is for a demolition• permit, what year was the building constructed?
Ifpnor to 1975, you will need an asbestos assessment to submit with this application.
❑ Duplex
O Retail
Preservation
Description of work Remove existing roof, install all needed flashin s, felt, shingles.
Z Ds
i
*If lawn sprinkler/backflow preventer, must list licensed plumber. If first-time A/C, must list licensed
Subco ntractors: List the crnmpany name or City of Ft Collins license 9
Electrician Plumber Mechanical Roofer R-1408
electrician.
Other
I
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 Instruction. I know that a
permit is not valid until it has been paid and issued. I
Applicant:
Print Name: Jennifer Aldrich Signature) �bt�cQ� Date 3-3-14