HomeMy WebLinkAbout4238 GEMSTONE LN - APPLICATIONS - 10/15/2019City of
281 N College Ave. 970-416-2740
Fort Collins, CO 80524 buildingservices@fcgov.com
Job Site Address eL (3el" s4o�7Q La Ciiy/StatelZipFdCe/co/z'pOS2S
Property Owner Information ll /^
Name SIA-PI SI-OrLe f owrr- 0tj- eS Lord Phone Number 2002 - 92 8!
Address 2/21 ///lcxCity/StatefZipFOca/co ICY052.T
Q Single Family Detached Townhome (attached) Q Duplex 0Apartment/Condo QGarage/Other
tri a c fu j Q Bank Q Bar Q Church Q Hotel/Motel Q Medical Office Q Office Q Retail 0 Restauran
COMMERCIAL STRUCTURES
Are you tearing off existing roofing materials to the decking? O Yes 0 No
If keeping existing layers, how many layers are there? What kind of material are they?
iWhat new roofing materials are you using?
! Is there existing insulation? Q Yes Q No
Will any insulation be removed/replaced? Q Yes O No
-5�c'�7 9' ��
Materials /
Manufacturer C �/iF # of Squares �� # of Stories
FLAT ROOF (less than 2:12 pitch) 0 Yes O No
0 Roof Repair 49% of roof area max. Class 4 shingle is not required. Note lotation(s) of aieas
s �r, to be repAireedd in space
Ida,
Roof Repair 50% or more of roof area: Class 4 shingle is required. I provided below. -
Additional Information (if applicable)
Contractor Information
Name 2 co /p000c
Address G / e Z 4e:r SIL /City/State/Zip l%ny��/So2 2 T
Phone Number Email-/UnoA'7 ��/a/Pcr�.2oo<a�c/So�nr• core,
License %� ?8 / 3 �f / Certificate y yy 2 7
�? Q License/Certificate Holder ® Payroll Employees Q Exempt Roofer (1099): EX-
4: 0 Homeowner Company Name:
Pri Id me " 0'/�44-n