HomeMy WebLinkAbout1320 ROBERTSON ST - APPLICATIONS - 1/27/2012City 0,
,Fort Collins
Planning, Development & Transportation
281 N. Collece Ave
Fort Collins, CO 80524
Phone 970-416-2740 Fax 224-61_14
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 # Date
For office use only
Job Site Address (required)
Value of Construction (labor, materials, profit)
1320 Robertson St
2700
Property Owner Name Address
City/State Zip
Phone
Robert Rollin 2101 E CR30
Ft Collins 80525
226-3355
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 R. Collins Sales Tax #
Are you paying taxes here or by report?
0 Here ❑ Report
.wi tax number isreyu edbyailcon&acmrs.
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 H64vire Pieservadba
If this is for a demolition permit, what year was the building constructed?
Ifpnor to 1975, you will need an asbestos assessment to submit wRh this applkatlon.
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 City of Ft Collins license #
Electrician Plumber Mechaniml Roofer R-1408 Other
I hereby acknowledge that I have read this application and state that the above information is complete and correcL 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: Brian Hill
i.: D1,U11, ei,W by BMn Hit
Deco: 2012.01.27 10AB21
Signature '0T0P Date 1/27112