HomeMy WebLinkAbout2908 S Timberline Rd - Special Inspections/Field Verification - 01/05/2021Planning, Development, and Transportation
Community Development & Neighborhood Services
281 N. College Ave. - PO Box 580
Fort Collins, CO 80522
970.416.2740
970.224.6134 - fax
fcgov.com/nbs
City of Fort Collins
Roofing/Re-Roofing Field Verification Form
_______________________________ _____________________________
Job Site Address Permit Number
A roofing permit was obtained for the above address. This building exceeds the City’s ability to
access the roof safely. As you are listed as the licensed roofing contractor on this job, you are
required to complete this form in lieu of the City Inspection.
Roofing Shingle Used (UL 2218)
Place a check everything that was completed.
( ) Decking replaced
( ) Flashing Installed Where?______________________________________________________
( ) Cricket or Saddle Installed (ridge side of any chimney or penetration greater than 30 inches)
( ) Ice and Water installed 2 feet inside exterior wall line of building.
( ) Drip Edge at eaves and rakes
( ) Fastening shingles to meet 140 mph wind load.
( ) Seal all penetrations
( ) Roof Ventilation How? _______________________________________________________
( ) Skylights reinstalled (Place sill flashing behind black rubber gasket)
( ) Roof installed per manufacturer guidelines
“I hereby certify that the roofing installed at the listed address complies with all applicable City
of Fort Collins Residential or Commercial building codes as amended or adopted.
_____________________ _______________________________ ______________________
Roofing Company Name
_______________________
Date
Certificate Holder Name (Print) License #
_________________________________
Certificate Holder (Sign)
If exempt workers used, please list the City of Fort Collins Exempt Worker Crew:
_____________________________________________________________________________________
Exempt Company Name Registered Exempt Worker (Print) Registration #
Please submit this form to Roofing@fcgov.com for processing and approval
2908 S Timberline B2012910
Architectural Sheet Metal / Panels - MBCI Standing Seam Metal
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Anchor Roofing LLC Jeramiah Larsen R-2446
1/5/2021