HomeMy WebLinkAbout601 MATHEWS ST - APPLICATIONS - 12/12/2019Date
Application #
281 N College Ave. 970-416-2740
Fort Collins, CO 80524 buildingservices@fcgov.com
ALL information is KhEJUIKLU. Incomplete applications will not ne acceptea.
Property Owner Information
Name
Address l20'S Hof-*,%
Phone Number R'4CD q 7 Q Col 16tt
City/State/Zip Fo f i- C'6l1)' +i
e 0 Single Family Detached Q Townhome (attached) O Duplex OApartmenUCondo 0) Garage/Other
(� a G Bank Q Bar p Church Q Hotel/Motel Q Medical Office %Office Q Retail ® Restaurant
COMMERCIAL STRUCTURES
Are you tearing off existing roofing materials to the decking? O Yes O 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? 0Yes Q No
Will any insulation be removed/replaced? a Yes Q No
Value of Construction
Residential rand Commercial = Labor and Materials $
Materials /y
Manufacturer AY J\Q M� 2Sr11 e- LDz # of Squares # of Stories
FLAT ROOF (less than 2:12 pitch) O Yes 0) No
O Roof Repair 49% of roof area max. Class 4 shingle is not required. Note locallon(s) of areas
to be repaired in space
Roof Repair 50% or more of roof area. Class 4 shingle is required_ - provided below
Additional Information 15 Avl ffj' t`�t2 Xe ,i�,-.yr%r -1-Ae.S Ka-9z ZitL 90,^ag-e 5
(if applicable)
Contractor Information
Name
Address a ik-, e _litre S i. -z z c--- City/State/Zip
Phone Number Email 6A. - Q <Pue✓a Iuen-k-i e r I cam -v- ,
License 0- - 2 Is- -2 Certificate 31, -Z Y — z
0 License/Certificate Holder 0 Payroll Employees
Si Exempt Roofer (1099): EX- �/
Company Name: IuiO l5n�ti'/a,,h Septic 5
Print Name
Signature
orl
Date