HomeMy WebLinkAbout144 N College Ave - Special Inspections/Field Verification - 01/09/2019Planning, Development & Transportation Services
City.of Community Development & Neighborhood Services
/� ■ 281 North College Avenue
FL) CO`l'ns P.O. BoxCollins,580
?'•�— Fort llns, CO 80522.0580
970.416.2740
970.224.6134-far
fcgov.com
City of Fort Collins
Roafing/Re-Rooting Field Verification Form
(Above Two -Stories)
�All(eae
Job Site Address ermi Number
A building permit (re -roofing) was obtained for the above address. This building exceeds the City's
ability to 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 Roofing/Re-Roofing Field Yerificalion 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 permit closed.
"1 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 the
roofing materials used on this project were installed per the manufacturer's instructions in high -wind
areas."
11
Company Nam q Certitipate Holder Nat a (Print) Lic nse #
i
Dalertificate Holder
If the work was performed on the aforementioned permit using a City of Fort Collins Registered Exempt
Worker crew, please acknowledge below:
Exempt Company Name
Date
Registered Exempt Worker (Print) Registration #