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HomeMy WebLinkAbout3902 Moore StreetFrom: no-reolvCalci.wheatridae.co.us To: CommDev Permits Subject: Online Form Submittal: PERMIT APPLICATION Electrical Service Change/Upgrade/Electrical Work Date: Friday, March 4, 2022 12:10:54 PM CAUTION:This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe. Report any suspicious activities to the IT Division. PERMIT APPLICATION Electrical Service Change/Upgrade/Electrical Work This application is exclusively for RESIDENTIAL ELECTRICAL SERVICE CHANGE OR UPGRADE (200 amps or less). 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 Yes electrical service change or upgrade - 200 amps or less? PROPERTY INFORMATION Is this Residential or Residential Commercial? Property Address 3902 Moore St Wheat Ridge CO 80033 Property Owner Name Vaughn Seibold Property Owner Phone 303-638-7664 Number (enter WITH dashes, eg 303-123- 4567) Attach City of Wheat 3902 Moore St Wheat Ridge CO 80033 CC.Ddf Ridge Electronic Payment Form - "DO NOT ATTACH A PICTURE OF A CREDIT CARD" CONTRACTOR INFORMATION Contractor Business Titan Solar Power CO Name Contractor's License 202247 Number (This is a 5 or 6 digit number for the City of Wheat Ridge) Contractor Phone 480-237-2375 Number (enter WITH dashes, eg 303-123- 4567) Contractor Email copermitting@titansolarpower.com Address Retype Contractor copermitting@titansolarpower.com Email Address DESCRIPTION OF WORK Is this an electrical Upgrade service upgrade or change? Number of Amps 200 Location of work house (garage, house, etc) Provide additional N/A details, if needed. Project Value (contract 5000.00 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 has been issued and posted on the property. I certify that I have Yes been 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 Jonathan Villa Pe rm it Email not displaying correctly? View it in your browser. From: no-reolvCalci.wheatridae.co.us To: CommDev Permits Subject: Online Form Submittal: PERMIT APPLICATION Solar PV Installation Date: Wednesday, February 23, 2022 11:14:09 AM CAUTION:This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe. Report any suspicious activities to the IT Division. PERMIT APPLICATION Solar PV Installation This application is exclusively for Solar PV Installations YOU MUST ATTACH A VALID ELECTRONIC PAYMENT ORM 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 Yes Solar PV Installation? PROPERTY INFORMATION Property Address 3902 Moore St Wheat Ridge CO 80033 Property Owner Name Vaughn Seibold Property Owner Phone 303-638-7664 Number (enter WITH dashes, eg 303-123- 4567) Property Owner Email vseiboldl973@gmail.com Address Attach City of Wheat Ridge Electronic Payment Form - "DO NOT ATTACH A PICTURE OF A CREDIT CARD" CONTRACTOR INFORMATION Contractor Business Titan Solar Power CO Name Wheat Ridge 202247 Contractor's License Number (This is a 5 or 6 digit number for the City of Wheat Ridge) Contractor Phone 480-237-2375 Number (enter WITH dashes, eg 303-123- 4567) Contractor Email copermitting@titansolarpower.com Address Retype Contractor copermitting@titansolarpower.com Email Address DESCRIPTION OF WORK Scope of Work Installation of a 6.29 MN DC solar system and a Main Panel Upgrade. KW 6.29 # of Panels 17 Location of Panels house roof Structural required No Upload engineer letter 3902 Moore St Wheat Ridge CO 80033 SL.odf or pages on 8 1/2" x 11" only Solar Installation Plan 3902 Moore St Wheat Ridge CO 80033 Plans ndf Set on 11 "x17" only. Project Value (contract 28431.00 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 has been issued and posted on the property. I certify that I have Yes been authorized by the legal owner of the property to submit this application and to perform the work described above. Person Applying for Jonathan Villa Pe rm it 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. Email not displaying correctly? View it in your browser. INSPECTION RECORD INSPECTION ONLINE FORM: http://www.ci.wheatridge.co.us/inspection INSPECTION REQUEST LINE: (303) 234-5933 Oc anc /T e tz/� Inspections will not be performed unless this card is posted, -on the project site. "Request an inspection before 11:59 p.m. (midnight) to receive an inspection the folio*ing business day.** Inspector Must Sign ALL Space's"' pertinent to this project Foundation Inspections Date Inspector Initials Initials Pier Concrete Encased Ground (CEG) Foundation / P.E. Letter Do Not Pour Concrete Prior To Anoroval Of The Above Insnectlonf. ' / Underground/Slab Inspections Date Inspector Comments Initials Electrical Comments Sewer Service 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. Plumbing Do Not Cover Underaround or Below/In-Slab Work Prior To At)Droval Of The Above Insnections Rough Inspections Date Inspector Initials Comments Wall Sheathing 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. Mid -Roof Fire Inspection / Fire Protection Dist. Lath / Wall Tie Final Plumbing Rough Electric Final Mechanical Rough Plumbing/Gas Line Roof r Rough Mechanical Final Building Rough Framing 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. 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 r 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 low voltage permits — Please be sure that rough inspections are completed from the Fire District and electrical low voltage by the Building Division. Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued Protect This Card From The Weather City of Wheat Ridge Residential Roofing PERMIT - 201703036 PERMIT NO: 201703036 ISSUED: 07/01/2017 JOB ADDRESS: 3902 Moore ST EXPIRES: 07/01/2018 JOB DESCRIPTION: Residential Re -roof to install Owens Corning Duration 30 year asphalt shingles with 19.4 sq. *** CONTACTS *** OWNER (303)638-7664 SEIBOLD VAUGHN SUB (720)328-1971 Todd Halaburka 110084 Aspen Roofing & Exteriors LLC *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 4,985.80 FEES Total Valuation 0.00 Use Tax 104.70 Permit Fee 125.05 ** TOTAL ** 229.75 *** COMMENTS *** *** CONDITIONS *** 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 one half 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 manufacturer 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 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 Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax ' .r INSPECTION NOTICE Inspection Type: Job Address: qbc*�_ Permit Number: :-;)Gl7©,3j)�� ❑ No one available for inspection: Time AM,/�M Re -Inspection required: Yes -"No _.f m When corrections have been made, c11 fior re -inspection at 303-234-5933 Date: % Inspector:�— DO NOT REMOVE THIS NOTICE ► A City of Wheat Ridge Residential Roofing PERMIT - 201703036 PERMIT NO: 201703036 ISSUED: 07/01/2017 JOB ADDRESS: 3902 Moore ST EXPIRES: 07/01/2018 JOB DESCRIPTION: Residential Re -roof to install Owens Corning Duration 30 year asphalt shingles with 19.4 sq. *** CONTACTS *** OWNER (303)638-7664 SEIBOLD VAUGHN SUB (720)328-1971 Todd Halaburka 110084 Aspen Roofing & Exteriors LLC *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 4,985.80 FEES Total Valuation 0.00 Use Tax 104.70 Permit Fee 125.05 ** TOTAL ** 229.75 *** COMMENTS *** *** CONDITIONS *** 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 one half 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 manufacturer 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 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 Residential Roofing PERMIT - 201703036 PERMIT NO: 201703036 ISSUED: 07/01/2017 JOB ADDRESS: 3902 Moore ST EXPIRES: 07/01/2018 JOB DESCRIPTION: Residential Re -roof to install Owens Corning Duration 30 year asphalt shingles with 19.4 sq. I, by my signature, do hereby attest that the work to be performed shall comply with all accompanyingg 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 a14 -work to be perfortnekd is dtsv4osed in this document and/ojr its' accompanying approved plans and specifications. Signature of OWNER or CONTRACTOR (Circle one) Date ' - 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 ermit 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 an 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 re uired inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuan anting of a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any applicable cod any ordma egulation 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. Inspection time requests will be accepted by email only. Please email requests to insptimerequestgei.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. Dane Lovett From: no-reply@ci.wheatridge.co.us Sent: Tuesday, June 20, 2017 10:44 AM To: Permits CommDev Subject: Online Form Submittal: Residential Roofing Permit Application Residential Roofing Permit Application This application is exclusively for new permits for residential roofs and for licensed contractors only. This type of permit is ONLY being processed online --do not come to City Hall to submit an application in person. Permits are processed and issued in the order they are received. YOU WILL BE CONTACTED WHEN YOUR PERMIT IS READY FOR PICK-UP AND WILL BE GIVEN A SPECIFIC DATE AND TIME WINDOW TO COMPLETE THE TRANSACTION. You will be notified if your contractor's license or insurance has expired, and you may update those documents at the time you are issued your permit. Permits are currently being processed within 3-5 business days, subject to change based on volume. For all other requests: Homeowners wishing to obtain a roofing permit must apply for the permit in person at City Hall. Revisions to existing permits (for example, to add redecking) must be completed in person at City Hall. All other non -roofing permits must be completed in person at City Hall. The Building Division will be open from 7:30-10:30 a.m., Monday through Friday to process these types of requests. THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN REROOFING UNTIL PERMIT HAS BEEN ISSUED. Is this application for a Yes residential roof? How many dwelling units Single Family Home are on the property? PROPERTY INFORMATION Property Address Property Owner Name Property Owner Phone Number Property Owner Email Address 3902 Moore St Vaughn Seibold 3036387664 Field not completed. Do you have a signed Yes contract to reroof this property? It will need to be provided at the time of permit pick-up. CONTRACTOR INFORMATION Contractor Name Contractor's License Number (for the City of Wheat Ridge) Contractor Phone Number Aspen Roofing & Exteriors 110084 7203281971 Contractor Email Address Elizabeth.aspenroofing@gmail.com (permit pick-up instructions will be sent to this email) Retype Contractor Email Elizabeth.aspenroofing@gmail.com Address DESCRIPTION OF WORK Are you re -decking the roof? Description of Roofing Material Select Type of Material If "Other" is selected above, describe here: How many squares of the material selected above? Does any portion of the property include a flat roof? If yes, how many squares on the flat roof? No Owens Corning Duration 30yr Asphalt Field not completed. 18.10 No V Field not completed i TOTAL SQUARES of all roofing material for this project Provide additional detail here on the description of work. (Is this for a house or garage? What is the roof pitch? Etc) 19.40 House and shed Project Value (contract 44.5 — 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 this Yes application is NOT a permit. I understand I will be contacted by the City to pay for and pick up the permit for this property. I understand that work Yes may not begin on this property until a permit 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. Name of Applicant Elizabeth Pinder Email not displaying correctly? View it in your browser. 3 4§rR28&,1E' xteriors 7500 W. Mississippi Ave Suite B-145 Denver, Colorado 80226 (303) 900-4116 Locally Owned and Operated www.AspenRoofingandExteriors.com Fully Licensed and Insured PROPOSAL RESPECTFULLY SU`BMrITED TO: Name Address City, St. Telephone9�T Alt. No SCOPE OF WORK: Re- Roof ❑New Construction Tear Off xisting Roof 7–L SQ W/ Waste 4 Type Layers ! Replace oven/ Damaged, Decking as necessary CD OSB COOLPLY Felt Paper 15# 30 # X SYN Closed Valley System 2 " Galvanized Valley Flashing e and Water Shield in "�Vafley (s) Chimn y (s) Metal Drip Edge Color�f 03 � 2" x 2" 2" x 4" Roofing Nails 1 %4" 1 1/2" , SAT Dish -1v/14' Fg–Starter Strip ReFlash Chimney(s) W and other walls as needed Wood Brick El Reflash Skylights # _L— License info on back. WORK TO BE PERFORMED AT: Date �O �� ,$ ,; Date 1 e5– i Address City, St. Material Location Insurance Company_ J Ventilation Ridge Vent Air Hawks Win&,bi]n Power Vent Remove Replace Keep [Pipe lack 1 Y " 2" 3" 4„ Roof Vents 4" 8" 3 t all Vents to Match Shingle Color emove ALL Trash from Gutters/ Job Site agnetic Nail Sweep Yard and Driveway ool Cover 1111VIl!f Place Aspen Roofing & Exterior Sign in Yard Yr.Wo 1 ship Warranty Notes: tlr k n f li�yes Z Z — 2 i' , ntractor is entitled to Overhead d�n claims involves 3 or more trades IMA�NIUFACTURER: HIP & RIDGE WARRANTY GAF ELK – Certainteed- Atlas High Ridge 3 Tab wens Coming T ���Q� 3 Tab (standard) 25 yr. SHLNG OR: r , `' (Length) Architectural NOTES/ EXTRA: �' f 30 yr 40 yr f•t��� �t��c}s�.�1 JF 50 yr/ lifetime ADDITIONAL DET Z Property Owner is / / is not intending to make payment TOTAL PROPOSAL. PRICE: S From the proceeds of a property and casualty insurance policy DUE UPON ACCEPTANCE: $ 00 ZZ � Cust initials DUE UPON COMPLETION: S S% Process' eel ® J *Plus Permit & Supplements (tet int Respectfully Submitted By: Aspen R mg sales Rep (signature i Aspen Roofing & Exteriors les Rep (print, Sales Rep Cell a By signing this c frac [ owledge all terms and conditions on the reverse sid . "Know our Rights and Duties" Homeowner Signature Date Homeowner (Print n ) Homeowner Signature Date Homeowner (Print name) i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax l% INSPECTION NOTICE Inspection Type: Job Address: Permit Number: %01 %(J _„fib ❑ No one available for inspection: Time1 Al/;p Re -Inspection required: Yes No When corrections have been made, ccl` & re -inspection at 303-234-5933 I Date: (y/ I-7 % Inspector: 6 DO NOT REMOVE THIS NOTICE INSPECTION RECORD Occugancv/Tvae IV - INSPECTION LINE: (303) 234 -5933 Inspections will not be made unless this card is posted on the building site Call by 3:00 PM to receive inspection the following business day. I - SCE d °l. I r. Viz= 1. INSPECTOR MUST SIGN ALL SPACES PERTAINING TO THIS JOB FOUNDATION INSPECTIONS DATE INSPECTOR INITIALS COMMENTS: Footings /Caissons Stemwall / (EEG) Concrete Encased Ground Reinforcing or Monolithic Weatherproof / French Drain Sewer Service Lines Water Service Lines INSPECTIONS FOR PLANNING &ZONING, FIRE AND PUBLICE WORKS SHOULD BE CALLED AT LEAST ONE WEEK PRIOR TO FINAL INSPECTIONS. VR V RC I C V IV I IL X6V V C I'IAJ 6[[IV JIGNCU CONCRETE SLAB FLOOR Electrical Heating (Underground) ROUGHS Sheathing Lath / Wall tie Mid -Roof Electrical Service Rough Electric Rough Plumbing Gas Pioina Rough Mechanical Insulation Drywall Screw FINALS Electrical Plumbing Mechanical Roof Building Final Fire Department R.O.W & Drainage INSPECTIONS FOR PLANNING &ZONING, FIRE AND PUBLICE WORKS SHOULD BE CALLED AT LEAST ONE WEEK PRIOR TO FINAL INSPECTIONS. Parking & Landscaping "NOTE: ALL ITEMS MUST BE COMPLETED AND APPROVED BY PLANNING AND ZONING, BUILDING AND PUBLIC WORKS BEFORE A CERTIFICATE OF OCCUPANCY IS ISSUED. FINAL INSPECTION BY THE BUILDING DIVISION DOES NOT CONSTITUTE AUTHORIZATION OF A CERTIFICATE OF OCCUPANCY NOR PERMISSION FOR OCCUPANCY. OCCUPANCY NOT PERMITTED UNTIL CERTIFICATE OF OCCUPANCY IS ISSUED PROTECT THIS CARD FROM THE WEATHER r . . £- ♦ Ls r. . 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 074- e%e� -srT Permit Number i . ❑ No one available for inspection: Time * YY A Re- Inspection required: Yes Date: /%f Inspector: DO NOT REMOVE THIS NOTICE " ' City of Wheat Ridge _(- -0063 Carl Seibold Residential Roofing PERMIT - 110376 PERMIT NO: 110376 ISSUED: 04/11/2011 JOB ADDRESS: 3902 MOORE ST EXPIRES: 04/10/2012 DESCRIPTION: Remove and replace 19 sqs of asphalt shingles * ** CONTACTS * ** owner 303/422 -0063 Carl Seibold go 303/425 -7531 John Borfitz 01 -9983 J & K Roofing Inc. ** PARCEL INFO ** ZONE CODE: UA USE: UA SUBDIVISION: 0813 BLOCK /LOT #: 0/ ** FEE SUMMARY ** ESTIMATED PROJECT VALUATION: 4,883.00 FEES Permit Fee 125.05 Total Valuation .00 Use Tax 87.89 ** TOTAL ** 212.94 - - •n�" -%- 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 naaja4 within this document as parties to the work to be performed and that all work to be performed is disclosed in this do e and r its' accom in ° � pproved plans and specifications. of OWNER or f CONTRACTOR (Cjlrcle one) 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 Chief Building Offical Date INSPECTION REQUEST LINE: (303)234 -5933 BUILDING OFFICE: (303)235 -2855 REQUESTS MUST BE MADE BY 3PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.. City of Wheat j - e COMMUNITY DEVELOPMENT Building & Inspection Services Division 7500 W. 29 Ave., Wheat Ridge, CO 80033 Office: 303 - 235 -2855 ' Fax: 303 - 237 -8929 Inspection Line: 303 - 234 -5933 Building Permit Application Date: Plan # Permit # Property Address: ' L AAOC Y-P, c`l' -"720 Property Owner (please print): Carl � bQ � J Phone: 4T7,- 00(� Mailing Address: (If different than property address) Address: -; �>qO ` Z /40 Qtre S+ . City, State, Zip: J ry � l,�h-e� 4- 'Or CJR Co Contractor: Contractors City License #: Phone: �� I Sub Contractors: Electrical: Plumbing: Mechanical: City License # City License # City License # Description of work CRS &" ULl �j �9 Review Fee (due at time of submittal): Squares I BTU's Gallons _Amps Sq Ft_ $ 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 ovmer of any entity included on this application to list that entity on this application. CIRCLE ONE (OWNER) (CONTRACTOR) or (AUTHOR /ZED PRINT NAME: l 1 ZONING COMMENTS: Zoning: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: DEPARTMENT USE ONLY (CONTRACTOR) 11 PUBLIC WORKS COMMENTS: OCCUPANCY: Reviewer: FIRE DEPARTMENT:: 0 approved w/ comments ❑ disapproved D no review requited Bldg Valuation: $