HomeMy WebLinkAbout2631 Antelope Rd - Applications/Reroof - 02/06/2020Cl y �r
Fort Colons CC,
Job Site Address
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Date
Application #
City/State/Zip
Proporfy O nior hiftrmatiun.�J,
Name 3 P7 [4/z)&/ & Phone Number 9�0 2Z�
Address City/State/Zip I a s Single Family Detached Q Townhome (attached) Q Duplex QApartmentrCondo Q Garage/Otl er
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s fd t!, j* � Y Q Bank Q Bar Q Church Q Hotel/PAotel Q Medical Office Q Otfice Q Retail Q Restaurant
CO MPOLR:CIAL SIRUC CURES
Are you tearing off existing roofing materials to the decking? Q Yes Q No
If keeping existing layers, how many layers are there? What kind of material are they?
What new roofing materials are you using?
Is there existing insulation? Q Yes Q No Will any insulation be removed/replaced? Q Yes Q No
Manufacturer
n�k�T� I 7,7,
Manufacturer C` / # of Squares G
FLAT ROOF (less than 2:12 pitch) p Yes 0No
Q Roof Repair 49°% of roof area max. Class 4 shingle is not required.
YRoof Repair 50°% or more of roof area. Class 4 shingle Is required.
Additional Information (if applicable)
Name
Address
Phone Number
Email
# of Stories Z_
Note location(s) of areas
to be repaired in space
provided below.
License Certificate
4 4 1 License/Certificate Holder Payroll Employees p Exempt Roofer (1099): EX-
Q Homeowner Company Name:
TL/V11
Print Name
Signature
Dat