HomeMy WebLinkAbout4348 WINTERSTONE DR - PERMITS - 6/30/2021City of
k tColli~
Site Address: 4348 WINTERSTONE DR
Job Valuation : $8 1 100.00 Category: Residential
Owner: SOU LONG BENOON
4348 WINTERSTONE DR
Community Development & Neighborhood Services
281 N. College Ave Fort Collins, CO 80522
970.221.6760 970.224.6134 -fax
Building Permit#:
Is sued Full:
B2105127
06/30/2021
Permit Type: Residential Roofing
FORT COLLINS, CO 80525 Phone: 970-779-5850
Zoning: Front setback Rear setback: Ri ght setback: ____ _ Left setback:
Minor Amend# ______ Plat File#: ______ ZBA Case #:
Zon in g d ist rict: RL -LOW DENSITY RESIDENTIAL DISTRICT
Legal: Subdivision/PUD
Code: Res sq ft:
_________________ Fil ing#:
Ind sq ft:
Lot# Block#: --------
Basement sq ft ________ _
# of stories: -=2:..__ __ _
Com sq ft:
0cc Group: Const Type ____________________ _
Fire Sprklr: Stock plan# ----Stock plan options: -------------------
Contractor: License#: Superviso r cert#:
Phone :
Subcontractor(s) Phone License Number
Work Description: Tear off existing shingles and re -roof 27 squares with Owens Corning Duration Storm Class 4 impact resistant
asphalt shing les. Provide required attic ventilation. Install required ice and w ater shield. Install shingles per manufacturer's high-wind
specifications . 2 Story. Homeowner affidavit on file .
Construction waste management plans are required to complete roofin g permits. Construction waste management plans can be
submitted electronically or emailed to envir onmentalcompliance@fcgov.com. *NOTE: If you are in receipt of a Le tter of Completi on ,
all requireme nts listed above have been completed*
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/mobile
Possible Inspections Required: 410 409 ·
TOTAL FEES PAID AS OF 06/30/21: $273.33
** Fee Detail Displayed on Next Page
Payment method: Credit Ca rd 1062
As a condition for the issuan ce of a permit, I hereby declare that I am the owner or owner's agent, authorized to perform the proposed work on the prop erty described herein.
I agree to comply with all the requ irements 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.
Signature: Print Name: Date: ----------------------------------------Form Revised Oct 2010
City of
~~tColli~
Site Address: 4348 WINTERSTONE DR
Community Development & Neighborhood Services
281 N. College Ave Fort Collins, CO 80522
970.221.6760 970.224.6134 -Jax
Building Permit#: B2105127
Issued Full: 06/30/2021
Permit Type: Residential Roofing
Job Valuation: $8,100.00 Category : Residential
Transactions
Method Check Number Date Psiid
Credit Card CK# 1062 06/30/2021
Receipt issued: 06/30/2021 Total Paid to Date:
Fee Descri~tion Account Code
City Sales/Use Tax 251.122030
County Sales/Use Tax 100 .217030
Permit Fla t Fee -$85 1000422010
TOTAL FEES :
Amount Paid Comments
$273.33
$273.33
Fee Amount Amo.unt Paid Date Paid
$155.93 $155.93 06/30/2021
$3240 $3240 06/30/2021
$85.00 $85.00 06/30/2021
$273.33 $273.33
TOT AL BALANCE DUE AS OF 06/30/2021:
Amount Due
$0.00
$0.00
$0.00
$0 .00
Fee Amounts are valid for date of th is document only. Fees subject to change without notice.
Form Revised Oct 201 O
20 -1 N CoU0g:} /:,,.v0.
f'c.,rt CoHins , CC) 80tl24
ROOFING PERMIT APPLICATION
970-416-27 40
bui!cJin9sorvicos@fcgov.corn
Date
Application # _
ALL information is REQUIRED. Incomplete applications will not be accepted.
Job Site Address 4348 Winterstone Drive City/State/Zip Ft. Collins, CO 80525
Prop@rty Owner !nformatron
Name Benoon Soulong Phone Number _9_7_0_-7_7_9_-_5_8_5_0 _______ _
Address 4348 Wi nterstone Drive City/State/Zip Ft. Collins, CO 80525
0 Townhome (attached) 0 Duplex (J Apartment/Condo C· Gara ge/Other
0 Hotel/Motel O Medical Office O Office 0 Retai l C• Restaurant
COMMERCIAL STRUCTURES
Are you tearing off existing roofing materials to the decking? (J Yes () 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 i nsulation? 0 Yes O No ............................................................................. , Will
Value of Construction
Residential and Commercial = Labor and Materials $
Materials
Manufacturer Ownen Comings Duration Storm # of Squares _2_7 ______ # of Stories _2 ______ _
FLAT ROOF (less than 2:12 pitch) C Yes OJ No
0 Roof Repair 49% of roof area max. Class 4 shingle is not required.
0 Roof Repair 50% or more of roof area .. Class 4 shingle is required.
Additional Information
(if applicable)
Contractor Information
Name N/A ---------------------------------------------
Address N/A ----------------------------City/State/Zip _N_/_A ________ _
Phone Numbe r N/A Email N/A ----------------
License N/A Certificate N/A ----------------
c-:-: License/Certificate Holder O Payroll Employees () Exempt Roofer (1099): EX-_____ _
(!) 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 buildi ng construction. I know that a permit is not
valid until It has been paid and issued.
City of
ktColli~
Bu ilding Services
PO Box 580
281 N College Av e
Fort Collins , CO 80524
970-4 16-2740 phon e 970 -22 4 -6134 fax
HOMEOWNER AFFIDAVIT
I/we, f!,e,.} D"\JN $ iJ½ l ,.u~L, , as owner(s) of record of the property located
At: 'f 3 /' f t-J 1 4/IE71--S,f-p,v e J) f2 • , Fort Collins, Colorado, hereby declare and attest
to the following: (please check only the one that applies):
OPTION 1:
□ I am/ we are acting on my/ our behalf for the purpose of obtaining a building permit and
personally constructing my/our home. The home to be constructed is on the above property and
will be my/our primary residence. I/we have not personally constructed any other new homes
in the Fort Collins city limits within the past 24-month period .
OPTION 2: /
10' I am/we are acting on my/our behalf for the purpose of obtaining a building perm it and
personally constructing an alteration or addition to my/our house, acting as our own general
contractor. The house to be altered is on the above property and is my/our personal p rimary
residence.
OPTION 3 :
□ I am/we are acting on my/our behalf for the purpose of obtaining a building permit and
personally constructing a non-structural alteration to my/our attached s i ngle fami ly dwelling
unit. The house to be altered is my/our personal primary residence. I am aware that I/we
cannot do any structural, electrical , plumbing or mechanical work and m ust hire
contractors/subcontractors who are currently licensed and insured with the City of Fort Collins .
I am/we are personally performing all of the work or hiring City of Fort Collins licensed trades people , or will be
continuously supervising unpaid volunteers (see Option 3 for attached dwellings). The work is directly related
to the construction of the above referenced home, which is described more fully on Permit Application#
"61 ,\,QC?l\1;=\ (obtained from the Building Services office).
I/we understand that any person(s) or agent(s) contracted to perform stru ctural wood-framing , plu m bing,
HVAC, electrical or roofing work, MUST BE licensed contractors in accordance with the regulation of the City
of Fort Collins.
I/we understand that failure to comply with any of the above conditions may result in revocation of any permits
associated with the above Permit Application number, forfeiture of any fees that have been collected , a Stop
Work Order and potentially a court summons.
Sign in the p resen ce of Notary Public
------;?:w~r-· ~~ Co-owner
he foregoing Affidav it was acknow1ledged before me on this ~__,a. ______ _
Re vised 6/10/2014