HomeMy WebLinkAbout421 E SWALLOW RD - APPLICATIONS - 9/22/2014Schroeder Roofing Inc
970-669-3532 p.1
Faof
ort 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 Cl 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 # INAN 11
For office use only
Date vl'jai
Job Site Address (required)
Value of Construction (labor, materials, profit)
4211423 E Swallow Rd
4300.00
Property Owner Name Address
City/State Zip
Phone
Curt Thompson •421/423 E Swallow Rd
Ft CollinslCO 80525
970-481-6192
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
Salestax number isrequired byall mntractors
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 Farnily 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 Ifyes, you may need to contactHiston'c Prpserrrdtion
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. 1 Story Sub Contractor
*If lawn sprinkler/baciTow 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 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.
Applicant:
Print Name: Candice Brumit: Signature 12 1 e 9/10/2014