HomeMy WebLinkAbout1179 Cloverdale Dr - Special Inspections/Field Verification - 10/30/2019 (5)Planning, Development & Transportation Services
City Of Community Development & Ncrgbborhoud services
F®rt Cotti s 281 Noah College Avenue
' ` ' Sox 580
Fort
Fort Collins.s
CO 845220580
970.4162T40
970224.6134- fax
jcgovcnm
City of Fort Collins
Roofing/Re-#Raofmg Field Verification Form
(Above Two -Stories)
I?q Clo✓eirdctt �r I BI9C)LO20(p
Job Site Address Permit 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 Roofugg.'Re-Roofrng Field Yerifrcafion 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.
"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 the
roofing materials used on this project were installed per the manufacturer's instructions in high -wind
areas."
RTC Roofing
Roofing Company Name
10/30/2019
Date
Josh Vicars
Certificate Holder ante (Print)
e Holder ame rgn
D683
License #
If the work was performed on the aforementioned permit Cuing a City of Fort Collins Registered Exempt
Worker crew, please acknowledge below:
Exempt Company Name Registered Exempt Worker (Print) Registration #
Dale