HomeMy WebLinkAbout8100 W. 44th AvenueCity of Wheat Ridge
Residential Roofing PERMIT - 201702177
PERMIT NO: 201702177 / ISSUED: 06/19/2017
JOB ADDRESS: 8100 W 44th AVE`V EXPIRES: 06/19/2018
JOB DESCRIPTION: RESIDENTIAL REROOF TAMO 30 YEAR ASPHALT SHINGLES - 23 SQ.
*** CONTACTS ***
OWNER (303)838-1204 ARELLANO ROSS J
GC (303)777-0333 Ron Tutton 021585 Homestreet Roofing Inc.
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 8,200.00
FEES
Total Valuation 0.00
Use Tax 172.20
Permit Fee 188.45
** TOTAL ** 360.65
*** 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 A/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€'"s 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.
l`71
INSPECTION RECORD
INSPECTION ONLINE FORM: http://www.ci.wheatridge.co.us/forms.aspx?fid=79
INSPECTION REQUEST LINE: (303) 234-5933
Occupancy/Type
I .)
Inspections will not be performed unless this card is posted on the 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 pertinent to this project
Foundation Inspections Date Inspector Comments
Initials
Pier
Concrete Encased Ground (CEG)
Foundation / P.E. Letter
Do Not Pour Concrete Prior To Approval Of The Above Inspections
Underground/Slab Inspections
Date Inspector Comments
Initials
Electrical
Comments
Sewer Service
Plumbing
Do Not Cover Under round or Below/In-Slab Work Prior To Approval Of The Above Inspections
Rough Inspections
Date
Inspector
Initials
Comments
Wall Sheathing
Mid -Roof
bF11 117,
A V
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
%/7/7
GA
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
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City of Wheat Ridge
Residential Roofing PERMIT - 201702177
1?900"
PERMIT NO: 201702177 ISSUED: 06/19/2017
JOB ADDRESS: 8100 W 44th AVE EXPIRES: 06/19/2018
JOB DESCRIPTION: RESIDENTIAL REROOF TAMO 30 YEAR ASPHALT SHINGLES - 23 SQ.
*** CONTACTS ***
OWNER (303)838-1204 ARELLANO ROSS J
GC (303)777-0333 Ron Tutton 021585 Homestreet Roofing Inc.
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 8,200.00
FEES
Total Valuation 0.00 _
Use Tax 172.20
Permit Fee 188.45 r'-
** TOTAL ** 360.65^
*** 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 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€"Is 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
Residential Roofing PERMIT - 201702177
PERMIT NO: 201702177 ISSUED: 06/19/2017
JOB ADDRESS: 8100 W 44th AVE EXPIRES: 06/19/2018
JOB DESCRIPTION: RESIDENTIAL REROOF TAMO 30 YEAR ASPHALT SHINGLES - 23 SQ.
1, 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 a ally authorized to include all entities named within this document as parties to the work to be
performed and that all wo Ge'per r iscl in this document ad/or its' acc mpanying approved plans and specifications.
/%7!
Signature of OWNER ord' RACTOYY(Circle one) Date
I . This permit was issued based the m ormation provided in the permit application and accompanying plans and specifications and is
subject to the compliance wit those documents, and all applicable statutes, ordinances, regulations, policies and procedures.
2• This permit shall expire 365 d ys 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 originalpermit 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 an manner shall be performed that shall results in a changeof the natural flow of water without prior and specific approval.
5• The permit holder shall notify the Building and Inspection Services Division m 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
applicabjc-code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection.
a
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 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.
X017 Ga.172
Antoinette Kulick
From: no-reply@ci.wheatridge.co.us
Sent: Sunday, June 11, 2017 5:54 PM
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. Wr✓ — Wil vu—
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.
PROPERTY INFORMATION
Property Address
Property Owner Name
Property Owner Phone
Number
Property Owner Email
Address
Do you have a signed
contract to reroof this
property?
It will need to be
provided at the time of
permit pick-up.
8100 W. 44TH AVE.
ROSS ARELLANO
303-838-1204
Field not completed.
Yes
CONTRACTOR INFORMATION
Contractor Name
Contractor's License
Number (for the City of
Wheat Ridge)
Contractor Phone
Number
HOMESTREET ROOFING, INC.
021585
303-777-0333
Contractor Email Address rontutton@msn.com
(permit pick-up
instructions will be sent
to this email)
Retype Contractor Email rontutton@msn.com
Address
DESCRIPTION OF WORK
Is this application for a Yes
new permit for a
residential roof?
Are you re -decking the No
roof?
Description of Roofing TAMO 30 YEAR
Material
Select Type of Material: Asphalt
If "Other" is selected Field not completed.
above, describe here:
How many squares of the 23
material selected above?
Does any portion of the
property include a flat
roof?
If yes, how many squares
on the flat roof?
No
Field not completed.
TOTAL SQUARES of all 23
roofing material for this
project
N
Provide additional detail HOUSE 5:12
here on the description of
work. (Is this for a house
or garage? What is the
roof pitch? Etc)
Project Value (contract 8200
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 RON TUTTON
Email not displaying correctly? View it in your browser.
3
NJ
i7 d E.
PH- 303-777-0333 t 4G
FAX 303-649-2194
V I-- qb _� - � 11/� 0
BBB
Ho eStreet
n...n x.n. a•r>,
ROOFING, INC. /
"Find us at Troubleshooter. corn
Tom Martino's exclusive referral lk
g
NAME
STREETI�,190 JJ�-%
c�
CITY..._��
PHONE,
E -NIHIL ADDRESS
DATE S j 1 �
ESTIMA
APPROXIMATE DATE OF SERVICE
H 1�-JT_ I-Lo'F We Propose t ,
To furnish material and labor complete in accordance with specifications below for sum of: $ ^�
Payment to be made as Failo�vs: _—_D. _— down, balance upon completion of work.
SPECIFICATIONS FOR LABOR AND MATERIAL
TERMS AND CONDITIONS
(please read arefully)
J Recover roof with
rJ Tear off --
Install felt
.J Style of shingles
J Color of shingles, t
J New Valleys
Ridge ......
J Galvanized Nails or Staples trZ V
J Replace pftrmbing;acks.rtj
J Paint root stacks — - -�
J Install fetal edging
U Turbine vents
0 Tar and gravel ..... .
J Year guarantcc on labor
HomeStreet Rooting, Enc. to furnish all
material and labor
-41 Permit furnished by HorileStreet Roofin , Inc.
i
Glean -u
p &haul orf all trash pF
rom neat
Roll yard with magnetic roller
Gutters cleaned of roofing debris 2-z'
=l Extra work .�} [� L7 a rI v
HomeStreet Roofing, Inc. will hold intrust any payor t from
the property owner until the contractor has delivered the
roofing materials to the jobsite or has performed a majority
of the roofing work on the property.
INSURANCE ALLOWANCE AGREEMENT
ilivo anree to retain Homestreat :Zoofina, Inc. Ic rep,«Ce and/or repair IhF roil cm
Ina p o.^,erty atcramen:io:net, comingent r.rxv, HomeStreet Rooing, Inc. otraranc my
wiLrmce, ccm^rrr,'s approval ar,d payment to Itawi sad work done, it is unJarstocd
anc ati•eed that HomeStreet Flaof ng, nc, is to c owar•: rrry nsurarce carrier ane. mea:
wi h daeir representetwn in cider to discuss lite repair u, ranlanemont work :o be done lU
the prope!ty. Upon nsurarcr, ca'rer's and HomeStreet Rnnar 7, Inc. agreenent to the
extew. ct the C manes ane Los, Df lixma them -r eSticct Roofing, Inc. may begin to work
on i d Proporty. HOVEOLNKER'S OI,T- F POCKET EXPENSE WILL NC,? EXCEEC,
HOMEOWNFR S NSURANCE ?0L10i` I, nl1r,:TIBLE FOR WORK At,H 'Ere UPOIN
SIZTIIKEEN TIT INSURANCE CAPRIER AND 10%11`STREE- Roof lig, ;ac, He;manwner
ats avisus to rov dr all necessary cocurnertat.on tnr claim lal c .rovicinu jitl pertiront
docj:nsnl,.t.e,n 1^ :dci:itat_
payment from :nSuidrica terrier hnd;or Mort;cage Cnrnpary.
HomeStreet Hor:lr1n, Inc. rswirvcs the rigltl o fin for s-al1emant Malm due to n'aleriar ar
later incrcases due to x storm errArcnment or iw r„rx>e rnrrasurrme.nts a•C proven :u be
incor;;;d.
Ail material �, gU. arrtead :o ba sr±ecifled .All work is to be corrplu:00 nil workrrian-
like. -rawer acco,ding to iuKJUFd pact r.Bs. Homeowner: h -reby acknovitlecge that
HomeStreet Rrrc•rng Inc may be sublet: to delays Occasioned to inclemeril wkLather,
IaLor rlisput s, r1r3t4iral A.1oracjemior in:.�.iranca card9r de ays AINch are ceyord lite
ntr of of HomeStreet Honitng. In and la' r by accx:pts Any de ays occasicned by or N or
all o` these dreumslaiices it the `n5t,llallon of your root. Homernvrer._rants fall access :o
the entire property for stag rig ane execution o' r'ork uriless otherw so agreed.
Alteration or devietbris from -he ahoy, speci.'icaliuris involving extra costs will be
raxwcuted cnly upon •mitten orders, and will hecomc an extra charge ovar and above the
eat:mato Also; HomeStroet Roo-fing, Inc. reserves the right tc file for supplement claim
dee tc material Or abOr price increases eua 10 the storm nnvironr-lent or if insura-ire,
fPcusuri?rrents SIH ,',rover. to be incorrect. Limtiix and material warranty cLlVw8 siding.
Honaec,rnc�r to carry hrR, Unmado and all necessary inxurarces. HomoStreet Routing,
Inc voll rot be rosporr:;:trlg for ary mmpresslon er decompsassion of the home that may
rc I :n wa i; or floors cr<acldr:g An rixtrn aha e will rc k; if a• v ,40in
9 g, stucco or buck
re n tial is nEipdej for p:caur instzalittler. nt roof ri sh ag Or gutter •eplarxrment. we wi:l
iliil ua rasac srh n 14r da -mages 1 + tl r.sr, ratan iS. f mate ?alt rued to bra rn^laced. in
the evil'is u any IEt a. action by the partes ar:si-g oil of this contract, the'osing pary
shall pay the pravail,ng pariv's reasonable auornays tees and cost in addition.:o all other
awarcicd relief.
insurance Comaany:
Policy No. -t: __......._.-_.
Date:.._.
Claim No.4: _ 713_.
Signature:
Data: _- ----� -- _-_i
ACCEPTANCE OF PROPOSAL
You have the right to rescind this contract and obiain a Full refund or any deposit within
72 hours after entering into the contract. If you Plan to use the proceeds of a property
insurance claim to pay for the roofing work you rrlay rescind this contract within
72 hours afLer you recieve notice from the insurer that the claim has been denied in whoie or in
part. Homestreet Roofing cannot pay, waive, or rebate the homeovner'S irsurance deauctible
in part or in whole. Cancella io occurring after the third day will incur a charge of
20 percent of the full can rag amo�Int or insurance claim amount, whichever is
applicable. / i/ -f1
Signature ' "'” i cf/v r
HomeStreet F,cottrg, Inc. Representative
OUR SURETY & LIABILITY INSURER;
David Leigh DBA 4 Corners Insurance Service
1857 Ensenada Way, Aurora, CO 800ll
Ph: 720-984.2471, Fax: 303-223-3350
Signature
s" -it � 0 �
.er'...—._ .
Signature
Hate of Acceptance S. /-
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: AD
Job Address: 2) y4 w qq TM AWS
Permit Number: zoI � 0Z.1-�-)
ryOT A �10F w4[4
P) cq,s L- l( C CA / l
rc,r4 / h S PVC 71v— p n
V1110 y 0 o r t�✓j't
7c4A-oP-,P- cd;--
LJ
d,-
❑ No one available for inspection: Time ) 2 AM/(9
Re -Inspection required: No
When corrections have been made, call for re -inspection at 303-234-5933
Date: IZ811,? Inspector: C.3 /4l
DO NOT REMOVE THIS NOTICE
NA
i CITY OF�WHEAT RIDGE
_:�9rBuilding Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: bo = b
Job Address: 7160 CJ y 9 -1 AV C
Permit Number: ZO/ % Off, 1 7 7
12 92 CL) ue A
LGiI --rc>r F i- c4 J
❑ No one available for inspection: Time AM/PM
Inspection required:Ye 2 No V�, c, j
When corrections have been made, call for re -inspection at 303-234-
Date:- 6LP?Inspector:_ 5L/ -
DO NOT REMOVE THIS NOTICE
I
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: o "�
Job Address: 9100 t-✓ yH ,,� ve
Permit Number: 2 i 70 2- / 7'7
❑ No one available for inspection: Time ANI
Re -Inspection required: Yes (��O)
When corrections have been made, call for re -inspection at 303 -234 -
Date: 7 1'210 Inspector: 6 A e
DO NOT REMOVE THIS NOTICE
rlhawj�'-
i 111111 �11111 1111111111111111 � pill
L IM, I
II'll li
201300933 ISSUED: 07/17/2013
8100 W 44th AVE EXPIRES- 07/17/2014
Removing and replacing 19 squares of asphalt shingles *Also includes
re-deck.*
*** CONTACTS ***
OWNER (303) 868-9241 ROSS ARELLANDO
GC (303)758-7663 Jason Gillis 090242 d-7 Roofing, L
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE:
SUBDIVISION CODE: 2406 / EEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0
*** COMMENTS ***
est that the work to be perfonned shall comply with all accompanyin approy f plans and s ecificati
! !
of Chrief Building Official Date
MUST BE MADE BY 3PM ANY BUSINESS DAY FOR INSPECTION y
t
t
Y of
�C(W)MUNrry DtvEL,(
61 ii I ii U1 I a. * 1 +M
I
E lectrical: Plumbing: Mechanical:
City License # City License # City License #
Squares U' Gallons
NAT A
OATC
(OWNER) (CO)WRACTOR)
Jilin Addre (if different than property address)
Address:
City, State, Z ip: �
C
PI
inspection type r --rrr
Job Address df W 1 4 r l Hc A ti!�
Permit Number / / �Z�?o
F
If� e to
AS L6 17(22,1 Lk'
Ei No one available for inspection: Time
Re- Inspection required:(Ye � No
When corrections have been made, call for re- inspection at 303- 2345933 `
Date: 13 1! Inspector: AP
s ,
s • rr ?
DO NOT REMOVE THIS NOTICE
" ' City of Wheat Ridge
r Mechanic PERMIT - 111220
PERMIT NO: 111220
ISSUED:
10/10/2011
JOB ADDRESS: 8100 W
44TH AVE
EXPIRES:
10/09/2012
DESCRIPTION: Replace
80% furnace
and 3 ton A/C
* ** CONTACTS * **
owner 303/838 -1704
Ross Arellano
sub 303/993 -9060
Premiere
Heating Air
11 -0179
Premier Heating and Air
** PARCEL INFO **
ZONE CODE: UA
USE:
UA
SUBDIVISION: 0324
BLOCK /LOT #:
0/
** FEE SUMMARY **
ESTIMATED
PROJECT VALUATION: 8,585.00
FEES
Permit Fee
100.00
Total Valuation
.00
Use Tax
154.53
WWW
** TOTAL **
254.53
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 ;�p;.OYed. c oolunsties with this permit. I further attest that I am legally authorized to include all
entities name.4...witnin this document s parties to the work to be performed and that all work to be performed is disclosed in
dy
this ent and /or it a' accompa ng approved plans and specifications.
Signature of " or CONTRACTOR (Circle one)
Date
1. This p05_11�was issued based on the information provided in the permit application and accompanying plans and
spec cations and is subject to the compliance with those documents, and all applicable statutes, ordinances,
gulations, 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 provisioB of any applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject
to field in(hection.
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
&�rcaperty �t4cfre5s � �-�", �-
Property Owner (please prmfj � c�'>
i`v°6aliing Address: (if c iffererit then property
From: jess
p Date:
Plan #
3 80433
Perm
iE g
-8929
address)
Kevtow rete taue artlme of SuoNwal)
Amps". Sq Ft. -
r�]!'Y➢FBZ TAN bING- AIi46AG' RFFMRNT'
y this perniit_appJication areaccurate acid do trot violate applicable ordinanceC ,
venapis, casements or restrictions of rgcor& that alLmeasurements shown and S
I ree In alxide�By all nditions printed -on this application and ihat'i assume full
SYheat Ridge:code an
s d ordinances for woit<mider any erm
pit issued baited ;on
sn authorized.hy the legal owner ofthe to perforin.flte :described work
ity included on this application to list, that entity on, this application.
rli'ORYZEp REPRESENT of (OEf�IVER) , (CONTRACTOR)
SIGNAI.Ui$k: - DATE:
�Ak2'FAllE6~�T tiSE Dt�lkY