HomeMy WebLinkAbout4700 REGENCY DR - APPLICATIONS - 1/8/2018Planning, Development & Transportation
FCity 281 N. College Ave P.O. Box 580
01ry}l Collins 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 ® 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 # �LIM Date
For orrIce use only
v8/18
Job Site Address (required)
Value of Construction (labor, materials, rofit)
4700 Regency Dr.
$11,300.00 33.50
SCd.
Property Owner Name Address
City/State Zip
Phone
Bill Greger 4700 Regency Dr. Fort Collins, CO 80526
(970) 223-4439
Applicant Name Address
City/State Zip
Phone
Craig Schultz 3864 Ash Ave.
Loveland, CO 80538
970 286-3014
Contractor Address
City/State Zip
Phone
Schultz Roofing & Repairs, LLC.
same as above
Contractor City of Ft. Collins Sales Tax #
Are you paying taxes here or by report?
® Here ❑ Report
Sales tax number is required by all contactors
Are you paying with your trust account?
❑ Yes 8 No
53342
Is this a residential or commercial project? ® Residential ❑ Commercial
If residential, is it: 12 Single Family Detached 13 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 mayneed to contact Historic Preservation
If this is for a demolition permit, what year was the building constructed?
If pnor to 1975, you will need an asbestos assessment to submit with this application.
Description of work Remove 1 layer of shingles install drip edges, ice shield on eaves, 1 ply synthetic felt re -
shingle with am o Heritage Natural Timber s mg es.
1 Story & 2 story
*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 Mechanical Roofer X 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.
. .r
Applicant: —�
Print Name: Craig Schultz Signature, Date
1 /8/18