HomeMy WebLinkAbout904 ELM ST - APPLICATIONS - 4/1/2020City of
f6rt Collins
Date
Application #
281 N College Ave. 970-416-2740
Fort Collins, CO 80524 buildingservices@fcgov.com
ALL information is c� REQUIRED. Incomplete appli cations will not be accepted.
Job Site Address ` 4 i S City/State/Zi p FV r 4f0/1/. CL� �'0�/ �
Property Owner ®In_foLrmation 1/ �j ,% Q
KIRRIP � 'VI k lGPIle_"c Phone Number G C D � D
Address 719 9 S. "d el �� 2
City/State/Zip /-r (411vl (0 20T
Single Family Detached 0 Townhome (attached) 0 Duplex OApartmenUCondo O Garage/Other
0 Bank � i Bar 0 Church 1Q Hotel/Motel 0- Medical Office - (-) Office d Retail
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?
What new roofing materials are you using?
Is there existing insulation? 0 Yes 0 No Will any insulation be removed/replaced? (:) Yes Q No
$ I 00
Materials /
Manufacturer U)� `J� �C �C N)"75 �d'2 M # of Squares C4 of Stories
FLAT ROOF (less than 2:12 pitch) 0 Yes 0) No
Q Restaurant
O Roof Repair 49% of roof area max. Class 4 shingle is not required. Nate locatfr n(s)# areas
fo 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 ko c k- q /1'
Address (C� ��C 1 � 11," Li'/iC L Y-'J,Q City/State/Zip
Phone Number f 710 y"`QcT�' T'l �iifl Email 19J�)'J rL1 t k-Y 1M 9 V,,)7 v1 v, &4- + C om
License `� 1'i Q 3 Certificate
O License/Certificate Holder O Payroll Employees *Exempt Roofer (1099): EX- 4
0 Homeowner Company Name: �/