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Home My WebLink About140 BOARDWALK DR - PERMITS - 6/28/2021City of k tColli~ Site Address: 140 BOARDWALK DR Community Development & Neighborhood Services 281 N. College Ave Fort Collins, CO 80522 970.221.6760 970.224.6134 -fax Building Permit#: Issued Full: B2105007 06/28/2021 Permit Type: Commercial Roofing Job Valuation; $11,100.00 Category: Commercial Remodel Owner: BOARDWALK DENTAL LLC 140 BOARDWALK DR FORT COLLINS, CO 80525-3153 Zoning: Front setback: Rear setback: Minor Amend#: ______ Plat File#: Zoning district: CG -GENERAL COMMERCIAL DISTRICT Legal: Subdivision/PUD Phone: 303-931-2086 Right setback: ____ _ ZBA Case# Lot#: -----------------Filing# Left s etback: Block#: Code: Res sq ft: 0 # of stories: ----- Com sq ft: 0cc Group : Ind sq ft: Basement sq ft ________ _ Fire Sprklr: Stock plan #: ___ _ Contractor: RUSTY BUCKET, LLC OBA TICO'S ROOFING PO Box 1326 Ft. Collins, CO 80522 Subcontractor(s) Roofing: RUSTY BUCKET, LLC OBA TICO Const Type Stock plan o ptions: __________________ _ License# R-3641 (+) Phone: 970-566-1884 Phone 970-566-1884 Supervisor cert #: License Number R-3641 (+) Work Description: Install 1 layer of overlay w ith new 60 mil TPO for 37 squares over dental office. Inst all req u ired i c e and wa te r shield. Install per man ufacturer's high wind specifications. R-30 m inimum insulatio n , maintain positi ve drainage. Payro ll employe es t o do the work . SCHEDULE INSPECTIONS: ** via Text Message: 888-406-6394 ** By Phone : 970 -221-6769 ** Online Portal: fcgov.com/CitizenAccess ** Online Portal via Mobile Device: fcgov.com/CitizenAccess/mob ile Possible Inspections Required: 410 409 TOTAL FEES PAID AS OF 06/28/21: $468.07 ** Fee Detail Displayed on Next Page Payment method: Credit Card 3049 As a condition for the issuance of a permit. I hereby declare that I am the owner or owner's agent. authorized to perform the proposed work on the property described herein. I agree to comply with all the requirements contained herein, and Ci ty ordinances. and State laws associated with such work. I understand that such permit may be revoked in the event that issuance was based on incorrect information. This pe rmit shall become null and void if the work authorized by such perm it is not co mmenced. suspended. abandoned or not inspected within 180 days from the date of such permit. Signature: Print Name: Date: --------------------------------------- Form Revised Oct 2010 City of k tColli~ Site Address: 140 BOARDWALK DR Community Development & Neighborhood Services 281 N. College Ave Fort Collins, CO 80522 970.221.6760 970.224.6134 -fax Building Permit#: 82105007 Issued Full: 06/28/2021 Permit Type: Commercial Roofing Job Valuation: $11,100.00 Category: Commercial Remodel Transactions Method Che~k Numb~[ D51te Paid Cred it Card CK# 3049 06/28/2021 Receipt issued: 06 /28 /2021 Total Paid to Date: Fee Descri~tion Account Code Ci ty Sales/U se Tax 251 .122030 Coun ty Sales/Use Ta x 100.217030 Permi t Flat Fee -$210 1000.4 22010 TOTAL FEES: Amount Paid Comments $468.07 $468.07 Fee Amount Amount Paid Date Paid $213.67 $213.67 06/28/2021 $44 .40 $44 .40 06/28/202 1 $210.00 $210.00 06/28/2021 $468.07 $468.07 TOTAL BALANCE DUE AS OF 06/28/2021 : Amount Due $0.00 $0.00 $0.00 $0.00 Fee Amounts are valid for date of this document only. Fees subject to change without notice. Fonn Revised Oct 2010 City of k _!_S oll~ ROOFING PERMIT APPLICATION Date _________ _ Application # 281 N College Ave . Fort Colltns , CO 8 0524 970-416-27 40 buildingservices@fcg ov.com ALL information is REQUIRED. Incomplete applications will not be accepted. Job Site Address 140 E. Boardwalk Dr. Property Owner Information Name Leon Green I fi.)IJidV\JfM {L, Ve,fl,l&d Address 140 E. Boardwalk Dr. City/State/Zip Fort Collins CO 80525 Phone Number _3_0_3_9_3_1_2_0_8_6 _______ _ City/State/Zip Fort Collins CO 80525 @RESIDENTIAL - ------">.-1--------- (' Single Family Detached ~ownhome (atta~hed) I Duplex (' ApartmenUCondo (' Garage/Other I Bank C Bar I Church (' Hotel/Motel (' Medical Office (' Office (' Retail I Restaurant COMMERCIAL STRUCTURES I Are you tearing off existing roofing materials to the decking? (' Yes ~No If keeping existing layers, how many layers are there? l What kind of material are they? _·[Pi-.:-_0=--------- 1 What new roofing materials are you using? _i~ ........ · ~ ......... '-~~--~.....,.,_.,,____,_._--"'"'------..,.--------- I is there existing insulation? t Yes I No ill any insulation be removed/replaced? r Yes ( No - - ------------ -~----~ -- i Value of Construction i Residential and Commercial = Labor a nd Materials $ I-~------- -------- -------- $ $ 11 , 1 00. 00 Materials Manufacturer 60 mil TPO # of Squares _3_7 ______ # of Stories _1 ______ _ FLAT ROOF (less than 2:12 pitch) (e Yes IJ No (' Roof Repair 49% of roof area max. Class 4 shingle is not required. (i' Roof Repair 50% or more of roof area. Class 4 shingle is required. I Note location(s) of areas j to be repaired in space J provided below. Additional Information Overlay on 1 layer with New TPO (if applicable) Contractor Information Name Rus ty Bu cket LLC dba Tico's Roofing Address PO Box 13 26 Phone Number 970-566-1884 License R-3641 ( +) Email Certificate City/State/Zip Fo rt Collins CO 80522 ticoroofing@hotmail.com 4018-R(+) (' License/Certificate Holder (e Payroll Employees (' Exempt Roofer (1099): EX-------1 ===.A._("' Homeowner Company Name: j