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141 <br />CITY RESIDENTIAL ROOFING PERMIT APPLICATION <br />ST.JOSEPH COUNTY CITY OF SOUTH BEND BUILDING DEPARTMENT <br />PROPOSED <br />PROJECT <br />ADDRESS: 537 River Ave. <br />South Bend 46601 <br />PAYMENT: <br />CHECK # <br />CARD ❑ <br />CASH ❑ <br />Address City Zip Township <br />PROPERTY OWNER: Elizabeth Sternki <br />PHONE NUMBER: EMAIL: <br />MAILING ADDRESS: 537 River Ave. <br />Address <br />South Bend IN 46601 <br />City State Zip <br />*SIGNED CONTRACT SHOWING COST OF CONSTRUCTION MUST BE PROVIDED UPON APPLICATION SUBMITTAL* <br />COST OF CONSTRUCTION: TEAR-OFF/RE-ROOF: $ 22.874.98 OR OVERLAY: $ <br />INCLUDES SOFFIT/FASCIA: YES ❑ NO <br />BUILDING CONTRACTOR:ASSCHER ROOFING CO. <br />PHONE: <br />ADDRESS: <br />574 234 9380 <br />OR OWNER AS CONTRACTOR ❑ <br />EMAIL: asscherroofing.com <br />1130 W. Western Ave. South Bend IN 46619 <br />Address City State Zip <br />*AII contractors must be registered with our department. For more information onthisgo to <br />htto:/lwww.so uthbendin.gov/government/content/contractor-licenses-0 <br />*Application can be emailed to us at building@southbendin.gov or provided to the address below for review. <br />*Application must be signed below. <br />I certifythe above to be a true and accurate tothe best of my knowledge. <br />7/19/2024 <br />APPLICANT SIGNATURE DATE <br />Renato Suasto <br />PRINT NAME ORG/BUSINESS OR OWNER <br /> <br />PHONE <br />renato@asscherroofing.com <br />EMAIL <br />EXCELLENCE ACCOUNTABILITY INNOVATION INCLUSION EMPOWERMENT <br />125 5. Lafayette Blvd. Suite 100 South Bend, Indiana 46601 p 574.235.9554 f 574.235.55411 www.southbendin.gov <br />