HomeMy WebLinkAbout2120 Clipper Way - Special Inspections/Field Verification - 12/04/2018Planning, Development & Transportation Services
Ci `®f Conlmnatty� Development& Niftchborhead Services
li 281 Atortir College Avenue
F6rt ColP.O. Boc 580
Fort Colons. CO 80522.0580
970.41G 2740
970Z24.6134-far
fcgorrom
City of Fort Collins
Roofing/Re-Roofing Field Verification Form
(Above Two -Stories)
Z- ra. Ci/ f�,C M2!fta
Job Site Address' �— Permit Number.
A building permit (re -roofing) was obtained for the above address. This building exceeds the City's
ability co access the roof for inspection with a standard two-story ladder.
You are the listed Fort Collins licensed roofing contractor of record for this project As such, you are
authorized to complete this Roo of" Field Verifica on Form in lieu of arranging for `the City
inspection. Please return the completed form to Building Services in order for the project to be approved
and the hermit closed.
"i hereby certify that the roofing installed at the above listed address complies with the applicable City of
Fort Collins Residential or Commercial building codes as amended and adopted. I further certify that Jre
roofing materials used on this project were installed per the manufacturer's instructions in high -wind
areas."
I ?1 I A
Roofing Company'N e
2 I
Date
Z,t.K& Mi6-14-ELSOA) -Z-Is
Certificate Holder Name. (Print) License r
icate Holder Name j
If the work was perfo „ed on the aforementioned permit using a City of Fort Collins Registered Exempt
Worker crew, please acknowledge below:
Exempt Company N < Registered Exempt Worker (Print)
Date
Ret