HomeMy WebLinkAbout1163 Duff Dr - Special Inspections/Field Verification - 10/30/2019Planning, Development & Transportation Services
City.QI Community Development& Neighborhood Services
FaCollins P.O. BoxSoCollege Avenuc
FanCDUhM CO80522.0580
970A16.2740
970224.6134- fiat
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{ City of Fort Collins 4
Roofing/Re-Roofing Field Verification Form
(Above Two -Stories)
MA-3 Duw-by, _19D() 591
Job Site Address I PermitNumber
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 Roe7ng.N-Raofrng Field Very1calion Form in lieu of aranging for the City
inspection. Please return the completed form to Building Services in order for the project to be approved
and the permit close&
"I hereby certify that the roofing installed at the above listed address complies with the applicable City or
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 ame (Print)
Ce f to Holder ame tgn
D683
License.#
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 Registered Exempt Worker (Print)
Dale
Registration #