HomeMy WebLinkAbout3401 Camelot Dr - Permits/Reroof - 12/10/2019City. Collins
Site Address: 3401 CAMELOT DR
Job Valuation: $3,601.73 Category: Residential
Owner: LEHMAN PATRICIA A
200 FANN RD
NOLENSVILLE, TN 37135
Community Development & Neighborhood Services
281 N. College Ave Fort Collins, CO 80522
970.221.676o 970.224.6134 -fax '
Building Permit#: B1916692
Issued Full: 12/10/2019
Permit Type: Residential Roofing
Phone:616-941-7487
Zoning: Front setback: Rear setback: Right setback: -Left setback:
Minor Amend #: Plat File #: ZBA Case #:
Zoning district: RL - LOW DENSITY RESIDENTIAL DISTRICT
Legal: Subdivision/PLID:
Code: Res sq ft: Com sq ft:
# of stories: 2 Occ Group:
Fire Sprklr: Stock plan #:
Contractor: AJ SHIRK ROOFING
330 N. Lincoln AVE STE 110
LOVELAND, CO 80537
Filing #: Lot #: Block #:
Ind sq ft:
Const Type: _
Stock plan options:
License #: R-1588
Phone: 970-669-6999
Basement sq ft:
Supervisor cert#:
Subcontractor(s) Phone License Number
Roofing: AJ SHIRK ROOFING 970-669-6999 R-1588
Work Description: Tear off existing shingles and re -roof 16 squares with Certainteed class 4 asphalt shingles. Provide required attic
ventilation. Install required ice and water shield. Install shingles per manufacturer's high -wind specifications. 2 story. Brothers
Rodriguez to do the work.
SCHEDULE INSPECTIONS: ** via.Text Message: 888-406-6394 ** By Phone: 970-221-6769
** Online Portal: fcgov.com/CitizenAccess ** Online Portal via Mobile Device: fcgov.com/CitizenAccess/mobile
Possible Inspections Required: 410 409
TOTAL FEES PAID AS OF 12/10/19: $158.74 Payment method: Trust Account
" Fee Detail Displayed on Next Page
As a condition for the issuance of a permit, I hereby declare that I am the owner or owners agent, authorized to perform the proposed work on the property described herein.
I agree to comply with all the requirements contained herein, and City ordinances, and State laws associated with such work. I understand that such permit may be
revoked in the event that issuance was based on incorrect information. This permit shall become null and void if the work authorized by such permit is not commenced,
suspended, abandoned or not inspected within 180 days from the date of such permit
Carbon Monoxide Alarm required within 15 feet of each bedroom entrance.
Signature:
Print Name:
Date:
Form Revised Oct 2010
Ft of.
Site Address: 3401 CAMELOT DR
Job Valuation: $3,601.73 Category: Residential
Transactions
Method Check Number Date Paid Amount Paid
Trust Account 12110/2019 $158.74
Receipt issued: 12/10/2019 Total Paid to Date: $158.74
Fee Description Account Code Fee Amount
City Sales/Use Tax 251.122030 $69.33
County Sales/Use Tax 100.217030 $14.41
Permit Flat Fee - $75 1000.422010 $75.00
TOTAL FEES:
$158.74
Community Development & Neighborhood Services
281 N. College Ave Fort Collins, CO 80522
970.221.676o 970.224.6134 -fax
Building Permit #: B1916692
Issued Full: 12/10/2019
Permit Type: Residential Roofing
Comments
r
Amount Paid Date Paid Amount Due
$69.33 12/10/2019 $0.00
$14.41 12/10/2019 $0.00
$75.00 12/10/2019 $0.00
$158.74
TOTAL BALANCE DUE AS OF 12/10/2019:
$0.00
0.00
Fee Amounts are valid for date of this document only. Fees subject to change without notice.
Form Revised Oct 2010