HomeMy WebLinkAbout601 MATHEWS ST - APPLICATIONS - 12/12/2019 (2)F6rt Collins
Date
• • • • • • • • • •
Application #
281 N College Ave. 970-416-2740
Fort Collins, CO 80524 buildingservices@fcgov.com
Job Site Address Cool Kamp WS Ise' City/State/Zip Fc,'4('0111'43/ G 905 Z$--
Property Owner Information
Name lo.� I"l %i q
Address
C} a Single Family Detached O Townhome (attached)
(J ® C Bank p Bar Q Church Q Hotel/Motel
Phone Number t 70 6) -7- ( J
City/State/Zip Gil-2q
Q Duplex OApartment/Condo G Garage/Other
Q Medical Office Q Office Q Retail Q Restaurant
COMMERCIAL STRUCTURES
i Are you tearing off existing roofing materials to the decking? O Yes p 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? aYes Q No Will any insulation be removed/replaced? 0Yes 0 No
Value of Construction
Residential and Commercial = Labor and Materials $ r•
Materials
Manufacturer Gm-- = # of Squares 2 `z- # of Stories Z
FLAT ROOF (less than 2:12 pitch) (0 Yes ®) No
a ® 0 Roof Repair 49% of roof area max. Class 4 shingle is not required. Note Iocatlon(s) of areas
to be repaired In space
e r; Roof Repair 50% or more of roof area. Class 4 shingle is required. provided below.
Additional Information lln I5 Qvt CkAe✓ �-In* roof- 15 4" 4L-
(if applicable) &e i n q &INJ w n 5 v e O le a zaQ 115-120 f�
Contractor Information
Name SeLxv,•C Li-. C
Address ?y- S
i�o�� es 2 Ay-2 <
Z z
City/State/Zilp ; - C61%ing/ Co, 00 ?
Phone Number 9-�o
Z2 3 -Zqs'
Email
t3A-"¢- Set1e✓2 comet/ tur✓c�o ��`� , �G�
License k- 2 I z
Certificate
312 y - F— '
O License/Certificate Holder 0 Payroll Employees (& Exempt Roofer (1099): EX-
®. o.p I 664UM
0 Homeowner Company Name: SAwi�
eve
Print Name Signatt Date