HomeMy WebLinkAbout2863 SITTING BULL WAY - PERMITS - 6/30/2021City of
k tColli~
Site Address: 2863 SITTING BULL WAY
Job Valuation: $5,576.00 Category: Residential
Owner: SIEMERS JEREMY L/MARY E
2863 SITTING BULL WAY
Community Development & Neighborhood Services
281 N. College Ave Fort Collins, CO 80522
970.221.6760 970.224.6134 -fax
Building Permit#: 82102328
Issued Full: 03/30/2021
Permit Type: Res id entia l Roofing
FORT COLLINS, CO 80525 Phone: 970-472-8104
Zoning: Front setback: Rear setback: Right setback: Left setback: -----
Minor Amend#: ______ Plat File#: _____ ZBA Case #:
Zoning district: LMN -LOW DENSITY MIX ED-USE NEIGHBORHOOD DISTRICT
Legal: Subdivision/PUD: ________________ Filing#: Lot #: 7 Block#: --------
Code: Res sq ft Com sq ft
0cc Group: # of stories: 2 ----Fi re Sprklr: Stock plan #: ___ _
Cont ractor: GORDO ROOFING LLC
113 CORONADO CT STE 201
FORT COLLINS, CO 80525
Subcontractor(s)
Roofi ng: GORDO ROOFING LLC
Ind sq ft: Basement sq ft: --------Const Type: ---------------------Stock plan options ------------------
License #: R-2078+
Phone: 970-231-7355
Phone
970-231-7355
Supervisor ce rt#:
License Number
R-2078+
Work Description: Tear off existing shing les and re-roof 17 squares w ith Owens Corning Class 4 impact resistant asphalt shingles.
Provide required attic ventilation. Install required ice and water shield. Install shingles per manufacturer's high-wind specifications . 2
Stories. Payroll employees to do the work.
Construction waste management plans are requ ired to complete roofing permits. Construction waste management plans can be
subm itted electronically or ema iled to environmentalcompliance@fcgov.com. *NOTE: If you are in receipt of a Letter of Completion,
all requi rements listed above have bee n completed*
SCHEDULE INSPECTIONS : ** via Text Message: 888-406-6394 ** By Phone : 970-22 1-6769
** Online Portal: fcgov.com/CitizenAccess ** Online Portal via Mobile Device : fcgov .com/CitizenAccess/mobile
Possible Inspections Required: 410 409
TOTAL FEES PAID AS OF 03/30/21: $214.64
•• Fee Detail Displayed on Next Page
Payment method : Credit Card 9567
As a cond ition for the issuance of a permit, I hereby declare that I am the owne r 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 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 permit shall become null and void if the work authorized by such pe rmit is not commenced,
suspended, abandoned or not inspected within 180 days from the date of such permit.
Carbon Monoxide Alarm requ ired within 15 feet of each bedroom entrance .
Signature: Print Name: Date: -------------------------------------
Form Revised Oct 2010
City of
k tColli~
Site Address: 2863 SITTING BULL WAY
Community Development & Neighborhood Services
2"81 N. College Ave Fort Collins, CO 80522
970.221.6760 970.224.6134 -fax
Building Permit#: 82102328
Issued Full : 03/30/2021
Permit Type: Residential Roofing
Job Valuation: $5,576.00 Category : Residential
Transactions
Method Check Number Date Paid
Credit Card CK# 9567 03/30/2021
Receipt issued: 03/30/2021 Total Paid to Date:
Fee Descri~tion Account Code
C ity Sales/Use Tax 251.122030
County Sales/Use Tax 100.217030
Permit Flat Fee -$85 1000.422010
TOTAL FEES:
Amount Paid Comments
$214.64
$214 .64
Fee Amount Amount Paid Date Paid
$107.34 $107.34 03/30/2021
$22.30 $22.30 03/30/2021
$85.00 $85.00 03/30/2021
$214.64 $214.64
TOTAL BALANCE DUE AS OF 03/30/2021:
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.
Form Revised Oct 2010
ROOFING PERMIT APPLICATION
Application #
281 N College Ave. 970-416-2740
Fort Collins, CO 80524 buildingservices@fcgov.com
ALL information is REQUIRED. Incomplete applications will not be accepted.
Job Site Address _.:,_Ql(;_{,,_3_~~~'-./-J_;vi.-<5-~8~.J_L+--( ~'µ~''='=)=->"'~------City/State/Zip A. f'o //i,.,,s , Cc) S::' 0 5-;1..5-
Property Owner Information
Name J!-('-{,~_ S t·-t'.,(,W.--, S Phone Number _,1L....:....?--=-o _·-_lf_r _2_-_<!"_f _o _'( _____ _
Address ,2<t;b] S vUtl,\,5 &..> I ( e,u".':'.r:= City/State/Zip hr-I-l:JI/),.,, S uJ f'-<JS~s-
0 Townhome (attached) 0 Duplex 0 ApartmenVCondo 0 Garage/Other
-.~ciMME·R~-IAL
' ' '_,,
0 Bank O Bar O Church O Ho t el/Mote l O Medical Office O Office Q Retail 0 Restaurant
----·---------. ----
COMMERCIAL STRUCTURES
Are you tearing off existing roofing materials to the decking? ® Yes O No
If keeping existing layers, how many layers are there?_~\__ What kind of materi al are they?
What new roofing materials are you using? __ C)_t.,U.._._~ ___ f.._.o-r-_11.-v'_•....,r~----SJ._a--r_vV'-_______________ _
Is there existing insulation? 0 Yes &No Will any insulation be removed/replaced? 0 Yes O No ---
---
. Value of Construction
1 R~si_den!ial a~~ ~o~~~r~~al __ ~ L~?.~~-and -~~~_r:!~ls -~ $
Materials
Manufacturer C)(;A-Q.tA-.5, Co,.. VL ~'s
FLAT ROOF (less than 2:12 pitch) Q Yes ) No
# of Squares __ /_-:;-, ____ #of Stories -----'2='-------
0 Roof Repair 49% of roof area max. Class 4 shingle is not required.
~oof Repair 50% or more of roof area. Class 4 shingle is require d.
Note loca tion(s) of are as
to be repaired i n space
provided below.
Additional Informa tion
(if applicable)
Contractor Information
Name futt-!of?oo ~V-
Address 1 \ "S l o--r on.Jo C-(-
Phone Number q 7-o-Q.. :> l -:t: 3 t;·--5-
'>--2D --, /', ~ License --"~""---~------------
Em a il
City/State/Zip ;q; cc1/f,bs , [0 ?"f:2.5-
tVLr 0,Vc (} o-rJ._p @ "1 a.two , {." Cl YL_
Certificate ______________________ _
f,<~~•!/0
/~: -::·r ~~: -~/?i1/.y; ·~•,-):<~~1~.~~
WORK PERFORMED BY /;'.¼
r~1;• :,'• ,'7 ~ ,•,•: r ' ~< •,:~,>!\
0 License/C;rtifi~ate H~lder 9lPayroll Employ~~s -0 Exempt Roofer (1099): EX-_____ _
0 Homeowner Company Name: ---------
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