HomeMy WebLinkAbout819 Boltz Dr - Applications/Reroof - 01/09/2020of
City Collide
Date
281 N Collette Ave. 970-416-2740
Fort Collins. CO 80524 buildin9servicss@fc9ov.com
Job Site Address 819 Boltz Dr
Property Owner Information
Name Patricia Lehman
.f
Application # Z az�D P
City/state/Zip Ft Collins, CO 80525
Phone Number (616)941-7487
Address 200 Fann Rd City/State/zip Nolensville, TN 37135
Single Family Detached i Townhome (attached)
(7-Duplex
r Apartment/Condo (7i Garage/Otherl -
(; e o
( Bank C Bar CChurch (-'Hotel/Motel
(-,medical Office
( Office i Retail C Restaurant
COMMERCIAL STRUCTURES
-- - - -- ---- -- -- - - - - - ---- -- - --- - — — — - - -- -- - -- - --- — --_-
Are you tearing off existing roofing materials to the decking? C Yes C No
{ If keeping existing layers, how many layers are there? What kind of material are they?
i What new roofing materials are you using?
Is there existing insulation? C' Yes ('' No
- - -- ------------- - -- - --
Will any insulation be removed/replaced? Yes C. No
Value of Construction
Residentia' and Commercial = Labor and Materials $
materials
Manufacturer Certaintee Northgate # of Squares 20 # of Stories 2
FLAT ROOF (less than 2:12 pitch) C' Yes (7l No
(7) Roof Repair 49% of roof area max. Class 4 shingle is not required. I Note locations) of areas
e ®° - i to be repaire in space 1
Roof Repair 5o% or more of roof area. Class 4 shingle is required. 1 provided below •.
Additional Information
(if applicable)
Contractor information
Name A.J. Shirk Roofing Company
Address 330 N Lincoln Ave #110
Phone Number 970-669-6999
License R-1588
City/State/zip Loveland, CO 80537
_ Email ajshirkroofing@msn.com
Certificate 1652-R
C License/Certificate Holder (-'- Payroll Employees (!-k Exempt Roofer (1099): EX-
C. Homeowner Company Name: 7 (/ A 1Y1 YI I f
Print Name Signature Moore Signature (/u -�� Date
1 /9/2020