HomeMy WebLinkAbout4751 Pleasant Oak Pl - Applications/Reroof - 03/25/2020 (23)I F(�-& , (0 (
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ROOFING PERMIT APPLICATION
281 N College Ave. 970-416-2740
Fort Collins, CO 80524 buildingservices@fcgov.com
I ALL information is REQUIRED. . -. t
Job Site Address 4 151 3?leabrtX* n&AL. J)ir ! LLO 1 k'S 6 L/ W• City/State/Zipyt (p Fi to S.N) 25
Property Owner Information 13 Lip
Name Maj: eC n-Z14, 9 \ CLLe- WM A Phone Number q'Z 0 • 'L23 - So 0 O
Address !:j3C5 i iV 14&&Q r& QCkk, Dr City/State/Zip fpY+(,oUlns . Lo 17�o
0 Single Family Detached %Townhome (attached) Q Duplex OApartment/Condo 0 Garage/other
am0 Bank 0 Bar 0 Church 0 HoteBMote1 0 Medical Office O Office 0 Retail 0 Restaurant
COMMERCIAL STRUCTURES
Are you tearing off existing roofing materials to the decking? ISNes 0 No
If keeping existing layers, how many layers are there? What kind of material are they?
What new roofing materials are you using? VV%*.1-aLAr L-C,V1 LS 6,01(,1J�
Is there existing Insulation? QYes 0 No Will any Insulation be removed/replaced? Oyes 0 No
Value of Construction^
Residential and Commercial = Labor and Materials $ i
Materials
Manufacturer MixLeX14cm # of Squares# of Stories
FLAT ROOF (less than 2:12 pitch) d Yes (�P No
0 Roof Repair 49% of roof area max. Class 4 shingle is not required. Note locatlon(s) of areas
® :1 to be repaired In space
Roof Repair 50% or more of roof area. Class 4 shingle Is required, provided below.
Additional Information
(if applicable)
Contractor Information
Name ii2_i1;+XA0
Address (y60'& S. (Z CL L.(y12_ (2,r 'J City/State)Zip tjgA1 1U 0J 1 0 Sl01j j
Phone Number �!LbB-1 q L{ • -3S -1 3 Email � ( ` O-I-{r1r a /�
License _ Q^ 3�� ` Certificate
ertificate Holder 0 Payroll Employees (0 Exempt Roofer (1099): EX- 1:15(
WOR{<PERFORiv}ED 9Y
w Homeowner Company Name: LLD ArycoymmaLA
Print Name s[z �/5/�'7
f�t219 CIEMr2i! signature �j, ��,r �vi Date