HomeMy WebLinkAbout3348 SAM HOUSTON CIR - PERMITS - 5/19/2021Site Address: 3348 SAM HOUSTON CIR
Community Development & Neighborhood Services
281 N. College Ave Fort Collins, CO 8052 2
970.221.6760 970.224.6 134 -fax
Building Permit#: B2103840
Issued Full: 05/19/2021
Permit Type : Residential Roofing
Job Valuati o n: $13,377.82 C ategory: Residenti al
Owner: MITCHELL CAROLINE
3348 SAM HOUSTON CIR
FORT COLLINS, CO 80526-2532
Zo nin g: Front setback: ______ Rear setback:
Minor Amend#: ______ Plat File#:
Ph o ne: 970-689-8462
Rig ht setback: ____ _ Left setback:
ZBA Case#: -----
Zoning district: RL -LOW DENSITY RESIDENTIAL DISTRICT
Legal: Subdivision/PUD: ________________ Filing#: Lot#: Block# --------
Code: Res sq ft:
# of stories:
Fire Sprklr:
Com sq ft:
0cc Group:
Stock p lan #: ___ _
Contractor: LION HOME SERVICE OBA DENALI ROOFING
4600 Innovation Dr., Ste . 102
FORT COLLINS, CO 80525
Subcontractor(s )
Roofing: LION HOME SERVICE OBA DENA
Ind sq ft: Basement sq ft: --------Const Type ____________________ _
Stock plan options: _________________ _
License #: R-4123 -----
Phone 970-939-0033
Phone
970-939-0033
Supe rvi so r cert#:
License Number
R-4123
Work Description: Tear off existing shingles and re-roof 25 squares with GAF Class 4 impact resistant aspha lt shingles. P rovide
requ ired attic ventilation . Install required ice and water shield. Install shingles per manufacturer's high-wind specif ications . 1 Stories.
GTO Roofing to do the work.
Construction waste management plans are required to complete roofing permits . Construct ion waste management plans can be
submitted electronically o r emai led to environmentalcompli ance@fcgov.com . *NOTE If you are in receipt of a Lett er of Completion,
all requirements listed above have been completed*
SCHEDULE INSPECTIONS: ** v ia Text Message: 888-406-6394 ** By Phone : 970-221-6769
** On line Portal: fcgov.com/CitizenAccess ** Online Porta l via Mobile Device : fcgov.com/CitizenAccess/mobile
Possible Inspections Required: 410 409
TOTAL FEES PAID AS OF 05/19/21 : $396.03
•• Fee Detail Displayed on Next Page
Payment method: Credit Card 7652
As a condition fo r the issuance of a permit, I hereby declare that I am the owner or owner's agent, authorized to perform the proposed wor k on the property described herein .
I agree to comply with all the requirements contained herein, and City ordinances , and State laws associa ted with such work. I understand that such permit may be
revoked in the event that issuance was based on incorrect information. This permit shall become null and void if the work authorized by such permit is not commenced ,
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 .
S_ ignature: Print Name: Date: -------------------------------------Form Revised Oct 2010
City of
,ktColli~
Site Address: 3348 SAM HOUSTON CIR
Job Valuation: $13,377.82 Category: Residential
Transactions
Method
Credit Card
Check Number
CK# 7652
Date Paid
05/19/2021
Receipt issued: 05/19/2021 Total Paid to Date:
Fee Description
City Sales/Use Tax
County Sales/Use Tax
Permit Flat Fee -$85
Account Code
25 1.122030
100.217030
1000.422010
TOTAL FEES:
Amount Paid
$396.03
$396 03
Fee Amount
$257.52
$53.51
$85.00
$396.03
Community Development & Neighborhood Services
281 N. College Ave Fort Collins, CO 80522
970.221 .6760 970.224.6134 -fax
Building Permit#: 82103840
Issued Full: 05/19/2021
Permit Type : Residential Roofing
Comments
Amount Paid
$257.52
$53.51
$85.00
$396.03
Date Paid
05/19/2021
05/19/2021
05/19/2021
Amount Due
$0.00
$0 .00
$0 .00
$0.00
TOT AL BALANCE DUE AS OF 05/19/2021:
Fee Amounts are va l id for date of this document only. Fees subject to change without notice.
Form Revised Oct 2010
~ l-,t O 1 ~()
Building Permit Over the Counter Application
2.
1. Job site address:
3348 Sam Houston Cricle
2. Property owner name:
Caro line Mitchell
3 . Property owner address:
Street Address: : 3348 Sam Houston Circle
City: : Fo rt Coll ins
State:: CO
Zip:: 80526
4 . Property owner phone number:
970-689-8462
5. Project type:
Residentia l
6. What type of residential?
Si ng le Fam ily De tached
7. Value of work (Labor and Materials)($):
13377.82
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:
25
11. Number of stories :
12. ls it a flat roof (less than 2:12 pitch)?
No
13. Check one :
Roof Repair 50% or more of roof area. Class 4 shingle is requ ired.
14. Contractor company name:
Lion Home Service OBA Denali Roofing Inc.
15. Contractor company address:
4600 In novation Dri ve, Su ite 102
16. Contractor phone number:
970-660-4417
17. Contractor company email:
swil liams@lion homeservice.com
18. License number:
R-4 123
19. Certificate number:
4970-R
20 . Work performed by:
Exempt Roofer (1099)
21. Exempt roofer name :
GTO Roofi n g
22. Exempt Roofer License EX __ :
2 18(R)
23. Additional Information if applicable:
3. Review
24 . I hereby acknowledge that I have read this applicati on and state that the above information is complete and
correct. I agree to comply with all requirements contained herein and c ity ordinances a nd state laws regulating
building construction. I know that a permit is not valid until it has been paid and issued.
Signature of: Sam Will iams
Date Signed :
05/18/2021
25 . Please include an email address to receive a confirmation and a copy of your answers.
sw illi ams@li onhomeservice.com
4. Thank You!
Thank you for submitting your application for processing.
To submit another over the counter application, click here.