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HomeMy WebLinkAbout4721 Estes Street�City of Wheat Ridge E -Res. Furnace Replacement PERMIT - 202000482 PERMIT NO: 202000482 ISSUED: 03/03/2020 JOB ADDRESS: 4721 Estes St EXPIRES: 03/03/2021 JOB DESCRIPTION: Replace 80K BTUs, 80% efficiency gas furnace in crawlspace *** CONTACTS *** OWNER (720)469-5236 GARCIA LORRAINE J SUB (303)659-3400 GEORGE DONALDSON 180142 FIX IT 24/7 HOME SERVICES, INC *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2002 / KIPLING, I-70 & CLEARCREEK ARE BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 6,750.00 FEES Furnace Replacement 40.00 Total Valuation 0.00 Use Tax 141.75 ** TOTAL ** 181.75 *** COMMENTS *** *** CONDITIONS *** Both the front and back of this permit are required to be posted on the job site at all times. If the complete permit is not present, inspections WILL NOT be performed. Work shall comply with 2012 IRC & 2017 NEC. Smoke alarms shall comply with 2012 IRC Section 134. INTERIOR ALTERATIONS, REPAIRS, FUEL -FIRED APPLIANCE REPLACEMENTS, OR ADDITIONS, ANY OF WHICH REQUIRE A BUILDING PERMIT, OCCURS OR WHERE ONE OR MORE ROOMS LAWFULLY USED FOR SLEEPING PURPOSES ARE ADDED SHALL HAVE AN OPERATIONAL CARBON MONOXIDE ALARM INSTALLED WITHIN FIFTEEN FEET OF THE ENTRANCE TO EACH ROOM LAWFULLY USED FOR SLEEPING PURPOSES PERMIT NO: JOB ADDRESS JOB DESCRIPTION City of Wheat Ridge E -Res. Furnace Replacement PERMIT - 202000482 202000482 4721 Estes St ISSUED° 03/03/2020 EXPIRES: 03/03/2021 Replace 80K BTUs, 80% efficiency gas furnace in crawlspace I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this ermIt. I further attest that I am legally authorized to include all entities named within this document as partres to the work to be performed and that all work to be per is disclosed in this document and/or its' accompanying approved plans and specifications. Signature of OWNER or CONTRACTOR (Circle one) Date I . This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Reqqu�ests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days madebe granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the original permit fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4 No work of any manner shall be performed that shall results in a changeof the natural flow of water without prior and specific approval. ivi 5, The permit holder shall notify the Building and Inspection Services Dsion in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and inspection Services Division. 6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, an violation of any provision of any applicable code..or any ordinanreor regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. City of Wheo� Ridgp U3/03/2O2O 15:l1 CDG� C0AU22433 AMOUHT 8PSP 4?21 E�tes St 18�.75 APB/PE8MlT HO- 2U2OOO482 Pv--- -rf A0� PP / 7635 181.?5 AUTH COUE� 72175863 T0TAL 01.?5 '------------------- Kimberly Cook DLU�L�q �a� I From: no-reply@ci.wheatridge.co.us Sent: Tuesday, March 3, 2020 12:38 PM To: CommDev Permits Subject: Online Form Submittal: Residential Furnace/Boiler Replacement Permit Application Categories: Kim Residential Furnace/Boiler Replacement Permit Application This application is exclusively for RESIDENTIAL REPLACEMENT FURNACE or BOILER - LIKE FOR LIKE ONLY. YOU MUST ATTACH A VALID CREDIT CARD AUTHORIZATION FORM IN ORDER FOR THE PERMIT TO BE PROCESSED. Your Permit will be emailed to the email address provided below once it is processed. THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN WORK UNTIL PERMIT HAS BEEN ISSUED. Is this application for a Yes replacement residential furnace or boiler like for like? PROPERTY INFORMATION Property Address Property Owner Name Property Owner Phone Number (enter WITH dashes, eg 303-123-4567) Property Owner Email Address Attach Credit Card Authorization Form - **DO NOT ATTACHED RANDOM FORMS 4721 Estes St John Roderick - Lorranie garcia 720-469-5236 gfruendt@fixmyhome.com Wheat Ridge cc authorization. pd CONTRACTOR INFORMATION Contractor Business Fix -it 24/7 Name Contractor's License 180142 Number (This is a 5 or 6 digit number for the City of Wheat Ridge) Contractor Phone 303-659-3400 Number (enter WITH dashes, eg 303-123-4567) Contractor Email Address gfruendt@fixmyhome.com Retype Contractor Email gfruendt@fixmyhome.com Address DESCRIPTION OF WORK What type of unit is being Furnace installed? Number of BTUs 80000 What is the efficiency 80 (%) of the unit? Is the unit GAS or gas ELECTRIC? Where is the furnace or crawlspace boiler located (for example, basement, crawlspace, etc)? Project Value (contract 6750 value or cost of ALL materials and labor) SIGNATURE OF UNDERSTANDING AND AGREEMENT I assume full Yes responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application. I understand that work Yes may not begin on this property until a permit 2 has been issued and posted on the property. I certify that I have been Yes authorized by the legal owner of the property to submit this application and to perform the work described above. I attest that everything Yes stated in this application is true and correct and that falsifying information in this application is an act of fraud and may be punishable by fine, imprisonment, or both. Person Applying for Gayle Fruendt Permit Email not displaying correctly? View it in your browser. 1k), A 16k_e�5 ��31_ INSAE TION RECORD INSPECTION REQUEST LINE: (303) 234-5933 Occupancy/'i ne Inspections will not be performed unless this card is posted on th - project site. Call the inspection request line before 11:59 p.m. to receive an inspection the following business day.** Inspector Must Sign ALL Spaces perti t - �s ject Foundation Inspections Date Inspector Comment Initials Pier Concrete Encased Ground (CEG) Foundation / P.E. Letter Do Not Pour Concrete Prior To Approval Of The Above Insnections Underground/Slab Inspections Date Inspector Comments Initials Electrical Sewer Service Plumbing Do Not Cover Underground or Below/In-Slab Work Prior To Approval Of The Above Inspections Rough Inspections Date Inspector Initials Comments Wall Sheathing Mid -Roof Lath / Wall Tie Rough Electric Rough Plumbing/Gas Line Rough Mechanical Rough Framing Rough Grading Insulation Drywall Screw / Nail Final Inspections Date Inspector Initials Comments Landscaping & Parking / Planning Dept. Inspections from these entities should be requested one week in advance. For landscaping and parking inspections call 303-235-2846. For ROW and drainage inspections call 303-235-2861. For fire inspections contact the Fire Protection District for your project. ROW & Drainage / Public Works Dept. Floodplain Inspection (if applicable) Fire Inspection / Fire Protection Dist. Final Electrical Final Plumbing Final Mechanical Roof , 1: -,17 ti Final Window/Doors Final Building NOTE: All items must be completed and approved by Planning, Public Works, Fire and Building before a Certificate of Occupancy is issued. Approval of the Final Building inspection does not constitute authorization of occupancy. "For iow voltage permits — Please be sure that rough inspections are completed from the Fire District and electrical low voltage by the Building Division. "For Inspection Time Window — Please email insptimerequest Ct7t ci.wheetridge.co.US by 8:00 A.M. the morning of the inspection with the property address in the subject line of the email. Time window is based on the inspector's route. Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued Protect This Card From The Weather City of Wheat Ridge Homeowner Roof PERMIT - 201700965 PERMIT NO: 201700965 ISSUED: 05/30/2017 JOB ADDRESS: 4721 Estes ST EXPIRES: 05/30/2018 JOB DESCRIPTION: Remove & replace 20 square Lifetime dimensional shingle (Owens Corning); Remove & replace 6 squares low slope torchdown - 26 squares total *** CONTACTS *** OWNER (720)251-5046 GARCIA LORRAINE J *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2002 / KIPLING, I-70 & CLEARCREEK ARE BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 12,099.95 FEES Total Valuation 0.00 Use Tax 217.80 Permit Fee 251.85 ** TOTAL ** 469.65 *** COMMENTS *** *** CONDITIONS *** I, the property owner, by my signature, attest that I currently reside at the project property, intend to reside at the property for a period of one year after completion of the project, and am personally performing all work, without the assistance of hired or professional workers. Consultations and inspections will only be performed with the homeowner of record present. Effective December 1, 2014, asphalt shingle installations require an approved midroof inspection, conducted when 25-75 percent of the roof covering is installed, prior to final approval. Installation of roof sheathing (new or overlay) requires an approved inspection prior to installation of ANY roof coverings and is require on the entire roof when spaced or board sheathing with ANY gap exceeding k/2 -inch exists. Asphalt shingles are required to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield is required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave and secured in place is required to be provided for all roof inspections. Roof ventilation is required to comply with applicable codes and/or manufacturera€rms installation instructions, whichever is more stringent. In order to pass a final inspection of elastomeric or similar type roof coverings, a letter of inspection and approval from the manufacturer's technical representative stating that "the application of the roof at (project address) has been applied in accordance with the installation instruction for (roof material brand name) roof covering" is required to be on site at the time of final inspection. i CITY OF WHEAT RIDGE _1�9�Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type:�2or Job Address:_—_777, Z i E S -T ST Permit Number: z© I �)Go I (-) S J ❑ No one available for inspection: Time'>AM/PM Re -Inspection required: Yes No When corrections have been made, call for re -inspection at 3103--234-5933 Date:. • I':1 ` %7 Inspector: ZZ � / DO NOT REMOVE THIS NOTICE City of Wheat Ridge Homeowner Roof PERMIT - 201700965 PERMIT NO: 201700965 ISSUED: 05/30/2017 JOB ADDRESS: 4721 Estes ST EXPIRES: 05/30/2018 JOB DESCRIPTION: Remove & replace 20 square Lifetime dimensional shingle (Owens Corning); Remove & replace 6 squares low slope torchdown - 26 squares total *** CONTACTS *** OWNER (720)251-5046 GARCIA LORRAINE J *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2002 / KIPLING, I-70 & CLEARCREEK ARE BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 12,099.95 FEES Total Valuation 0.00 Use Tax 217.80 Permit Fee 251.85 ** TOTAL ** 469.65 *** COMMENTS *** *** CONDITIONS *** I, the property owner, by my signature, attest that I currently reside at the project property, intend to reside at the property for a period of one year after completion of the project, and am personally performing all work, without the assistance of hired or professional workers. Consultations and inspections will only be performed with the homeowner of record present. Effective December 1, 2014, asphalt shingle installations require an approved midroof inspection, conducted when 25-75 percent of the roof covering is installed, prior to final approval. Installation of roof sheathing (new or overlay) requires an approved inspection prior to installation of ANY roof coverings and is require on the entire roof when spaced or board sheathing with ANY gap exceeding k/2 -inch exists. Asphalt shingles are required to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield is required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave and secured in place is required to be provided for all roof inspections. Roof ventilation is required to comply with applicable codes and/or manufacturera€ms installation instructions, whichever is more stringent. In order to pass a final inspection of elastomeric or similar type roof coverings, a letter of inspection and approval from the manufacturer's technical representative stating that "the application of the roof at (project address) has been applied in accordance with the installation instruction for (roof material brand name) roof covering" is required to be on site at the time of final inspection. City of Wheat Ridge Homeowner Roof PERMIT - 201700965 PERMIT NO: 201700965 ISSUED: 05/30/2017 JOB ADDRESS: 4721 Estes ST EXPIRES: 05/30/2018 JOB DESCRIPTION: Remove & replace 20 square Lifetime dimensional shingle (Owens Corning); Remove & replace 6 squares low slope torchdown - 26 squares total I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with thisermit. I further attest that I am le ally authorized to include all entities named within this document as parties to the work to be performed and that all work o be performed is disclosed in this document and/or its' accompanying approved plans and specifications. Signature of O R or CONTRACTOR (Circle one) Date 1. This permit was issued based on the infonnation provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the original permit fee. 3_ If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees and�procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a change of the natural flow of water without prior andspecific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 5. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, an violation of any provision of any applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief lit ff�rng Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Inspection time requests will be accepted by email only. Please email requests to insptimerequest@ci.wheatridge.co.us between 7:30am and 8:00am, the morning of the inspection. Please put the address of the inspection in the subject line. T� T City of VV /h6atRjgc_ /COMMUNITY DEVELOPMENT Building & Inspection Services Division 7500 W. 29" Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-23778929 Inspection Line: 303-234-5933 Email: permitstd)ci.wheatridcle.co.us FOR OFFICE USE ONLY Date: Plan/Permit # Plan Review Fee: Building Permit Application *** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: ` 7, F5fe_S _5 4 e ��'� D U a2�, Property Owner (please print): � 6-m Coq Phone: 'Z;: 0f rjy Property Owner Email: Mailing Address: (if different than property address) Address Citv. State. Zi Architect/Engineer: Architect/Engineer E-mail: Contractor: Contractors City License #: Contractor E-mail Address: Sub Contractors: Electrical: W.R. City License # Other City Licensed Sub: City License # Plumbing: W.R. City License # Phone: Phone: Other City Licensed Sub: City License # Mechanical: W.R. City License # Complete all information on BOTH sides of this form ❑ COMMERCIAL ❑ RESIDENTIAL Description of work: (Check all that apply) ❑ NEW COMMERCIAL STRUCTURE ❑ ELECTRICAL SERVICE UPGRADE ❑ NEW RESIDENTIAL STRUCTURE COMMERCIAL ROOFING ❑ COMMERCIAL ADDITION RESIDENTIAL ROOFING ❑ RESDENTIAL ADDITION WINDOW REPLACEMENT ❑ COMMERCIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.) ❑ RESIDENTIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.) ❑ MECHANICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT ❑ PLUMBING SYSTEM/APPLIANCE REPAIR or REPLACMENT ❑ ELECTRICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT ❑ OTHER (Describe) (For ALL projects, please provide a detailed description of work to be performed, including current use of areas, proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc.) Sq. Ft./LF Amps Btu's Squares Gallons Other Project Value: (Contract value or the cost of all materials and labor included in the entire project) OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any entity included on this application to list that entity on this application. CIRCLE ONE: (OWNS (CONTRACTOR) or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) a PRINT NAME: U r l �`) t" , i SIGNATURE. ri ✓ v ,i- a_. vi?ATE. x /% ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: PUBLIC WORKS COMMENTS: Reviewer: PROOF OF SUBMISSION FORMS Fire Department 0 Received ® Not Required Water District ® Received ❑ Not Required Sanitation District ❑ Received ® Not Required DEPARTMENT USE ONLY OCCUPANCY CLASSIFICATION: TYPE OF CONSTRUCTION: SPRINKLERED: OCCUPANT LOAD: Building Division Valuation: $ a� 41 CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: M I b Job Address: L) % 7- ) Q S'T r -S ST Permit Number: 20 )--7 0001 P ❑ No one available for inspection: Time /PM r� Re -Inspection required: Ye) No * When corrections have been made, call for rQ inspection at 303-234-5933 t i Date: Inspector: DO NOT REMOVE THIS OTICE �t s'_ S 7� a INSPECTION RECORD ( - )t d o r �r Occuoanc�vpe '�" INSPECTION REQUEST LINE: (303) 234 -5933 Inspections will not be performed unless this card is posted on the project site. Call the inspection request line before 3:00 p.m. to receive an inspection the following business day. Inspector Must Sign ALL Spaces pertinent to this project Foundation Inspections Date Inspector Initials Comments Monolithic Slab Reinforcement Sewer Service (Underground) Caissons Water Service (Underground) Concrete Encased Ground (CEG) Plumbing (Below/ In -slab) Footing /Stemwall P.E. Letter Heating (Below/ In -slab) UO NOT Pour GOncreTa Nr1Or i O Annrnvni C]t Tha Ahnvc Incnnrfinne Underground /Slab Inspections Date Inspector Initials Comments Electrical (Underground) Sewer Service (Underground) Water Service (Underground) Plumbing (Below/ In -slab) Heating (Below/ In -slab) Do Not Cover Underground or Below /In -Slab Work Prior To Approval Of The Above Inspections Rough Inspections Date Inspector Initials Comments Wall Sheathing ,�� �� plf Roof Sheathing Lath /Wall Tie Rough Electric Rough Plumbing Rough. Mechanical Gas Piping Do Not Proceed Without Approval Of Above Rough Inspections Rough Framing - Insulation Drywall Screw / Nair Final Inspections Date Inspector Initials Comments Final Electrical Final Plumbing Final Mechanical Roof Final Building / Frame Landscaping & Parking / Planning Dept. Inspections from these entities should be requested one week in advance. For landscaping and parking inspections call 303- 235 -2846. For ROW and drainage inspections call 303 - 235 -2861. For fire inspections contact the Fire Protection District for your project. ROW & Drainage / Public Works Dept. Fire Inspection / Fire Protection Dist. * *Note: AIM items must be completed and approved by Planning, Public Works, Fire and Building before a Certificate o Occupanc i s issued. A of the Fin Building in spection d not constitute authorization of occupa occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued Protect This Card From The Weather ❑ No one available for inspection: Time AM/PM Re-Inspection required: Yes No When corrections have been made, call for re-inspection at 303-234-5933 Date: 1 Inspector: 'DO NOT REMOVE THIS NOTICE V n f 4 r CITY OF WHEAT RIDGE Building Inspection Division r0000r (303) 234 -5933 Inspection line ` (303) 235 -2855 Office (303) 237-8929 Fax INSPECTION NOTICE Inspection Type O Job Address Permit Number E CITY OF WHEAT RIDGE Building Inspection Division (303) 234 -5933 Inspection line (303) 235 -2855 Office ' (303) 237 -8929 Fax INSPECTION NOTICE Inspection Type Job Address i c� aas r� Permit Number 111n44 +� CITY OF WHEAT RIDGE Building Inspection Division (303) 234 -5933 Inspection line (303) 235 -2855 Office " (303) 237 -8929 Fax INSPECTION NOTICE } inspection Type "-AAWVI- ,l P, Job Address V7,2I g.577S 57' Permit Number 11101e4 > ,���°' �+'a' YZ�Ixr✓Pa�Ft3 rra 8,� �n+t�;�.al6c� €a S�lPP> ��:� � . 0 a >2,feo 'Lr, z,> ---- .s.. s. tl 5 «' n Nn nnP nvniinhip. fnr incnartinn• Tima DPM 1� City of Wheat Ridge Residential Roofing PERMIT - 111066 PERMIT NO: 111066 ISSUED: 09/07/2011 JOB ADDRESS: 4721 ESTES ST EXPIRES: 09/06/2012 DESCRIPTION: Reroof /redeck, 23 squares' * ** CONTACTS * ** owner 720/251 -5067 Lorraine J. Garcia ** PARCEL INFO ** ZONE CODE: UA USE: UA SUBDIVISION: 0215 BLOCK /LOT #: 0/ ** FEE SUMMARY ** ESTIMATED PROJECT VALUATION: 6,500.00 FEES Permit Fee 156.75 Total Valuation .00 Use Tax 117.00 ** TOTAL ** 273.75 - Conditions: 6 nails per shingle is required. Ice dam membrane is required from eave edge to 2' inside exterior walls. Board sheathing with any gap greater than 1/2" requires panel sheathing overlay on entire roof. Sheathing inspection is required prior to covering. Contractor shall provide ladder for inspections. Scheduled inspections that cannot be performed due to inclement weather must be cancelled prior to 8:30 a.m.on the day of inspection or a re- inspection fee will be assessed. Subject to field inspection. I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this permit. I further attest that I am legally authorized to include all entities named within this document as parties to the work to be performed and that all work to be performed is disclosed in t � is document and /or its' accompanying approved plans and specifications. `YG a&t Nt ure of ' �dOIt CLC� - 7 191 _. rg or CONTRACTOR (Circle one) D 1. This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one- half of the original permit fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees and procedures for approval of any new permit. Re- issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of.Chi of TION REQU L Bld' cal Date INSPEC (303)234 -5933 BUILDING OFFICE: (303)235 -2855 REQUESTS MUST MADE BY 3PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. City of hest Date: 'M711 MMUNtTY DEVELOPMENT - Plan # Building &Inspection Services Division Permif# 7500 W. 29 Ave., Wheat Ridge, CO 80033 /lJ(p Office: 303 - 235 -2855 * Fax: 303 - 237 -8929 Inspection Line: 303 - 234 -5933 Building Permit Application Property Address: ' 6 w w 5� f Property Owner (please print): N)g0y yQ U fL� Mailing Address: (if different than property address) Address: City, State, Zip Contractor: LiCJ / Contractors City License #: Phone: Electrical: City License# bescription t7f �or§tt o D / cl C� FIR Plumbing: Mechanical: City License # City License # ontract Value /. 5 �� Bldg Valuation: N