HomeMy WebLinkAbout906 BENSON LN - APPLICATIONS - 7/16/2012Jul 16 12 03:02p Schroeder Roofing )
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970-669-3532 p.1
�yo,rt Collins
Planning, Development & Transportation
281 N. College Ave P.O. Box 58Q
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 (notservice 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.
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Application # ` w LG✓%�
") Date
For office use only
Job Site Address (required)
Value of Construction pabor, materials, profit)
906 Benson Ln
24
Property Owner Name Address
City/State Zip
Phone
Marcus Velasquez 906 Benson Ln
Ft Collins 80525
(970) 223-8678
Applicant Name Address
City/State Zip
Phone
Schroeder Roofing, Inc 1300 N Monroe Ave
Loveland, CO 80537
970-667-6777
Contracthr 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
sates tax .iumte�isrwuiredbyallwnbaciors.
Are you paying with your trust account?
0 Yes ❑ No
41047
Is this a residential or commercial project? IZk Residential ❑ Commercial
If residential, is it: m 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 Ifyes, you mayneed fn contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
Ifprior to 1975, you will need an. asbestos assessment to submit with then application.
of work Remove existing roof, install all needed flashings, felt, shingles and drip edge.
*If lawn sprinkleribackfiow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician.
Subcontractors: List bye company name or Oty of Ft Collins license #
Plumber Mechanical Roofer R-1408 Other
I hereby adviowledge 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: �/J
Print Name: Jennifer Aldrich Signature %'it.(� Date 7/16/2012
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