HomeMy WebLinkAbout200 S GRANT AVE - PERMITS - 5/19/2021Site Addres s : 200 S GRANT AVE
Community Development & Neighborhood Serv ices
281 N. College Ave Fort Collins, CO 80522
970.221.6760 970.224.6134 -fax
Bui lding Pe rmit#: 82103839
Issued F u ll: 05/19/2 0 21
Permit Type: Residential Roofing
Job V al u ation : $15,817.45 Category : Residential
Owne r: BOHM ANTON PEDRO WILLEM
200 S GRANT AVE
FORT COLLINS, CO 80521 Phone: 970-227-5904
Zo ning: Front setback: ______ Rear setback: _____ Right setback: ____ _
Minor Amend#: ______ Plat File# _____ ZBA Case #:
Zoning district NCL -NEIGHBORHOOD CONSERVATION -LOW DENSITY DISTRICT
Left setback:
Le gal: Subdivision/PUD: ________________ Filing#: Lo t #: B lock #:
Code : Res sq ft: ____ Com sq ft:
# of stories: 1 0cc Group:
Fire Sprklr ____ Stock p la n #: ___ _
Contra cto r: LION HOME SERVICE OBA DENALI ROOFING
4600 Innovation Dr., Ste. 102
FORT COLLINS , CO 80525
Subcontract o r(s)
Roofing: LION HOME SERVICE OBA DENA
--------
I nd sq ft: Bas ement sq ft : _______ _
Const Type: ____________________ _
St ock plan options: ------------------
License #: R-4123 -----
Phone: 970-939-0033
Phone
970-939-0033
Supervis or c e rt#:
License Number
R-4 123
Work Description: Tear off existing sh ingles and re-roof 24 squares with GAF Class 4 impact resistant as pha lt shin gles . P rov ide
required attic ventilation. Install required ice and water sh ield. Install shingles per manufacturer's high-wind specifications. 1 Stories.
GTO Roofing to do the work.
Construction waste management plans are required to complete roofing permits. Construction waste management plans c an be
submitted electronically or emailed to environmentalcompliance@fcgov.com *NOTE: If you are in r eceipt of a Letter of Completi on ,
all requi rements listed above have been completed*
SCHEDULE INSPECTIONS : ** via Text Message: 888-406-6394 ** By Phone: 970-221-6769
** On line Portal : fcgov.com/CitizenAccess ** On l ine Porta l via Mobile Device: fcgov .com /CitizenAccess/mobile
I Possible Inspect ions Requi red : 410 409
TOTAL FEE S PAI D A S OF 0 5/19/2 1 : $4 52.76 P a yme nt meth o d: C r edit Card 7652
•• Fee Detail Displayed on Next Page
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 descri be d herein.
I agree to comply with all the requirements contained herein , and City 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 perm it shall become null and vo id 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
Carbon Monoxide Alarm required within 15 feet of each bedroom entrance .
Signature: Prin t Na me: Date: -------------------------------------
Form Re vised Oct 2010
City of
,ktColli~
Site Address: 200 S GRANT AVE
Community Development & Neighborhood Services
281 N. College Ave Fort Collins, CO 80522
970.221.6760 970.224.6134 -fax
Building Permit#: 82103839
Issued Full : 05/19/2021
Permit Type: Res idential Roofing
Job Valuation : $15,817.45 Category : Residential
Transactions
Method
Credit Card
Check Numbe r
CK# 7652
Date Paid
05/19/2021
Receipt is s ued: 05/19/2021 Total P aid to Date :
Fee Description
City Sa l es/Use Tax
County Sales/Use Tax
Permit Flat Fee -$85
Account Code
251.122030
100.217030
1000.422010
TOTAL FEES:
Amount Paid
$452 .76
$452.76
Comments
Fe e Amount Amount Paid
$304.49 $304.49
$63.27 $63.27
$85.00 $85.00
$452.76 $452.76
Date Paid
05/19/2021
05/1 9/2021
05 /1 9/2021
TOT AL BALANCE DUE AS OF 05/19/2021:
Amount Due
$0.00
$0.00
$0.00
$0 .00
Fee Amounts a re valid for date of this document only . Fees subject to change without notice.
Form Revised Oct 2010
Building Permit Over the Counter Application
2.
1. Job site address:
200 S . Grant Avenue
2. Property owner name:
Ann Bohm -Sma ll
3 . Property owner address:
Street Address: : 200 S. Grant Avenue
City: : Fort Collins
State:: CO
Zip:: 80521
4. Property owner phone number:
970-227-5904
5. Project type:
Residential
6. What type of residential?
Sing le Family Detached
7 . Value of work (Labor and Materials)($):
15817.45
8. Type of permit:
Roofing
Please note: each individual lot requires a separate application and permit.
9. Manufacturer of materials:
GAF
10. Number of squares:
24
11 . Number of stories:
12. ls it a flat roof (less than 2 :12 pitch)?
No
13.Check one:
Roof Repai r 50% or more of roof area. Class 4 s hingle is required.
14. Contractor company name:
Li on Home Service DBA Den ali Roofing Inc.
15. Contractor company address:
4600 Innovation Drive , Suite 102
16. Contractor phone number:
970-660-4417
17. Contractor company email :
swi lliams@I ion homeservice .com
18. License number:
R-4123
19. Certificate number:
4970-R
20. Work performed by:
Exempt Roofer (1099)
21. Exempt roofer name:
GTO Roofing
22. Exempt Roofer License EX __ :
218(R)
23. Additional Information if applicable:
3. Review
24. I hereby acknowledge that I have read this application and state that the above information is complete and
correct. I agree to comply with all requirements contained herein and city ordinances and state laws regulating
building construction. I know that a permit is not valid until it has been paid and issued.
Signature of: Sam Wi ll iams
Date Signed:
05/12/2021
25. Please include an email address to receive a confirmation and a copy of your answers.
swilliams@lionhomeservice .com
4. Thank You!
Thank you tor submitting your application tor processing.
To submit another over the counter application, click here.