HomeMy WebLinkAbout6300 W. 46th Avenue► ' 41 City of Wheat Ridge
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Residential Roofing PERMIT - 201707631
PERMIT NO: 201707631 ISSUED: 09/25/2017
JOB ADDRESS: 6300 W 46th AVE EXPIRES: 09/25/2018
JOB DESCRIPTION: Residential Re -roof to install laminated asphalt shingles - 17 sq Pitch =
6/12
*** CONTACTS ***
OWNER (303)909-3290 HUSTON DUSTIN M
SUB (303)872-3327 Thad Frericks 170591 Simplified Restoration
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 4,369.00
FEES
Total Valuation 0.00
Use Tax 91.75
Permit Fee 125.05
** TOTAL ** 216.80
*** 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) is required on the entire roof
when spaced or board sheathing with ANY gap exceeding one half inch exists. Sheathing and
mid -roofs may be called in at the same time, one hundred percent of the sheathing must be
complete and 25-75 percent of the mid -roof may be complete. 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.
Midroof & Final Roof inspections for ROOFS 6/12 PITCH & OVER: 3rd party inspection will be
required, the 3rd party inspection report AND THE ORIGINAL PERMIT CARD needs to be dropped
off to the Permit Desk at the City of Wheat Ridge. The report MUST BE SIGNED by the
Homeowner.
City of Wheat Ridge
Residential Roofing PERMIT - 201707631
PERMIT NO: 201707631 ISSUED: 09/25/2017
JOB ADDRESS: 6300 W 46th AVE EXPIRES: 09/25/2018
JOB DESCRIPTION: Residential Re -roof to install laminated asphalt shingles - 17 sq
6/12
Pitch =
I by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specificationsz
applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized
by th ega xer of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with
this p her attest that I am legally authorized to include all entities named within this document as parties to the work to be
perfprme tat all work to be performed is disclosed in this document and/off its' accompanying approved plans and specifications.
Signaturebf_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 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 Budding 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 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 Build ° Uate
REQUESTS MUST BE MADE 59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
Dane Lovett
From: no-reply@ci.wheat ridge.co.us
Sent: Wednesday, September 20, 2017 11:52 AM'
To: CommDev Permits --'
Subject: Online Form Submittal: Residential Roofing Permit Application
Follow Up Flag: Follow up
2
Flag Status: Completed
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 and due to the volume of requests, time to process
varies and is subject to change. 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.
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 6300 W. 46th Ave.
Property Owner Name Dustin Huston
Property Owner Phone 303-909-3290
Number (enter WITH
dashes, eg 303-123-4567)
49
POO
Property Owner Email
Address
Do you have a signed
contract to reroof this
property?
Applications cannot be
submitted without an
executed contract
attached below.
Attach Copy of Executed
Contract
dustin.huston@gmail.com
Yes
scan0164.pdf
CONTRACTOR INFORMATION
Contractor Business Simplified Restoration
Name
Contractor's License 170591
Number (This is a 5 or 6
digit number for the City
of Wheat Ridge)
Contractor Phone 720-427-5461
Number (enter WITH
dashes, eg 303-123-4567)
Contractor Address 2950 S. Jamaica Crt. #306
(Primary address of your
business)
Contractor Email Address billing@simplifiedrestoration.com
Retype Contractor Email billing@simplifiedrestoration.com
Address
DESCRIPTION OF WORK
TOTAL SQUARES of
the entire scope of work:
Project Value (contract
value or cost of ALL
materials and labor)
Are you re -decking the
roof?
Is the permit for a flat
roof, pitched roof, or
17.00
3600.'00-
i
No
Pitched roof (2:12 pitch or greater)
50
both? (check all that
apply)
What is the specific pitch
of the PITCHED roof?
How many squares are
part of the PITCHED
roof?
Describe the roofing
materials for the
PITCHED roof -
Type of material for the
PITCHED roof:
Provide any additional
detail here on the
description of work. (Is
this for a house or
garage? Etc)
6/12
15.00
Laminated shingles
Asphalt
House/Detached Garage
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
51
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.
Name of Applicant Thad Frericks
Email not displaying correctly? View it in your browser.
52
General Contract
R
ADDRESS
ATE
CELL HOME
ZIP
EMAIL
INSURANCE COMPANY CLAIM DEPT. PHONE CLAIM#
NVIksurance Claim ❑ Cash Coact
Roofing (Ns, 6_'J
Gutters /AJ
Siding
Windows j)V S/- o(0
Paint IAJ! C
Stain Deck
Stain Fence
Interior work /
Other lk / Ni GUS �ti
Work not being done
Taxes
O/P
Start Date
ADDITIONAL INFORMA
SIMPLIFIED
RESTORATION
Gecrepa(ii(Pact4ty Made Star le!
2950 S. Jamaica Ct., Ste. 306
Aurora, CO 80014-2636
info@SimplifiedRestoration.com
SimplifiedRestoration.com
303.872.3327
$ /❑ .
Plus all Supplemental Insurance funds
Deductible
Home owner Contribution
Xi Gold Plan Silver Plan
Referral Bonus
006
91
MIME 7—$q"
V-� I
First Check (ACV)
Cash Back to Customer 96
Adjusted First Check Total
Estimated Final Check (RCV) .-3i (f 1. 3
Est. Time of Completion
Note: Final check will almost always be larger due to the supplemental process.
By signing this contract, Simplified Restoration has accepted and agreed to do project for insurance initial scope of work or Total Project Price. Customer gives permission to Simplified Restoration to supplement insurance
company for additional items and understands that additional monies may be approved by insurance company thru the supplemental process.
Customer agrees that all funds from insurance, either initially approved by insurance in the initial scope of work or thru the supplemental process is Simplified Restoration money unless otherwise noted on the contract.
Simplified Restoration Holds in trust all monies given to the company until all work has been completed in concordance with Colorado Senate Law S838.
This is the main contract, all subsequent contracts such as the roofing, siding, gutters and paint contracts explain in detail the scope of work Simplified Restoration will do and the material it will take to do subsequent projects.
Whether Project is an insurance claim or not, once an agreeable price is established, it shall become the authorized project price. The total Project price is the cost that it will take based on the damages known at the time
lWsxaaluct was entered into. It does not include insurance supplements. By signing this agreement, Customer agrees toal erms and conditions herein and authorizes Simplified Restoration to obtain material and
Tabor in acco e with the project price. Y ", /
`7,
CU
T
SIM
�L
RATION SIGNATURE
:OR THE PURPOSE OF THIS CONTR T, CUSTOMER IS DEFINED
IUPPLEMENT POLICY I Customer Initial
op The company reserves the right to file for supplemental Insurance claims, Supplemental insurance claims may consist of
items that were not covered on the claim or that are not paid at a full and fair market value. By signing this contract, customer
understands that all additional monies that are supplemented for are part of the total contract price thus are for Simplified
Restoration and must be paid to Simplified Restoration
Contract price is defined as the amount written on the front of the contract, plus all approved insurance supplemental
monies. Supplemental monies are not known until insurance issues a final approved total.
BY THE LEGAL HOME OWNER OF SAID PROPERTY. COMPANY IS DEFINED AS SIMPLIFIED RESTORATION.
i. By signing this contract, customer gives Simplified Restoration permission to work with the customer's insurance
company. Customer agrees to fully cooperate with Simplified Restoration in making sure that all items both on the claim or
missing be paid at a fair and full market value including all code items that may be covered. Customer agrees to give ALL
documents to Simplified Restoration that insurance provides customer it insurance company should not give documents
to Simplified Restoration, customer is responsible for requesting and giving Simplified Restoration any document needed
from the insurance company so Simplified Re to can have accurate numbers to finalize final invoice to customer.
Failure to do this may lead to a breach of cont n
t Terms of payment are as follows For Cash tract - tal contracted amount to begin work, 40% of contract upon
delivery of material, remaining 50% of contract when job is completed For insurance related restoration - First insurance
check is due upon delivery of material, unless otherwise noted on the contract or addendum. Final insurance proceeds are
due upon completion of the contracted projects, or when final insurance funds are received. (Note, all funds after initial
insurance fund distribution must be paid with insurance check )
i. With the first distribution of insurance money (first insurance check), customer may pay Simplified Restoration with a
personal check. Simplified Restoration will take care of any monies owed to customer at the time the first check is due.
Customer agrees that they will endorse and give Simplified Restoration any insurance check that is issued to them after
the first insurance check. CUSTOMER MAY NOT WRITE A PERSONAL CHECK AFTER THE FIRST INSURANCE INSTALLMENT OF
FUNDS, FAILURE TO GIVE INSURANCE CHECKS WILL RESULT IN FORFEITURE OF ANY BONUSES AND MAY RESULT IN A
BREACH OF CONTRACT, THE FINAL CONTRACT PRICE IS DETERMINED BY THE INITIAL AGREED UPON CONTRACT PRICE ON
THE FRONT OF THE CONTRACT, PLUS ANY ADDITIONAL SUPPLEMENTS APPROVED BY THE INSURANCE COMPANY.
i. For the purpose of this contract, completion is defined as the date which all work and projects Simplified Restoration is
contracted to do has been signed off on by the customer SIMPLIFIED RESTORATION WILL HAVE AWORK COMPLETE -
SATISFACTION FORM THAT CUSTOMER WILL SIGN OFF ON AS EACH TRADE THAT SIMPLIFIED RESTORATION IS
CONTRACTED TO DO IS COMPLETED.
r. Customer agrees that final payment is not contingent on any city, county, state or federal building permit being passed or
being signed off on. Customer must pay company when project is completed or when he/she receives final payment from
insurance company. Customer may not hold funds until any associated building permit to the projecl/projects are passed.
Customer agrees that building permits are a part of the Simplified Restoration warranty and that Simplified Restoration
warranties include all work will pass any and all city, county, state or federal building inspection. It any additional work
is required after completion in order to pass inspections, company agrees to perform the work necessary to obtain final
approval of said building permit.
3. Payment is due upon completion of contracted project. All payments must be paid at that lime unless it is an insurance
claim. If it is an insurance claim, all monies are due when customer receives final funds, or depreciation and supplemental
check from insurance company. Any portion remaining unpaid will bear an interest rate of twenty percent (20%) per
annum commencing thirty (30) days after completion. Purchaser agrees to pay reasonable collection fees and/or attorney
tees needed in pursuit of collecting any remaining unpaid portion commencing sixty (60) days after installation.
3. Failure to pay all amounts due within the terms of these agreed time periods will result in a (15%) late charge of the amount
owing to be paid by the customer to the company. Simplified Restoration will notify customer when insurance check have
been released. If insurance monies are not received in a timely manner (7-10 days from notification) then it is the customer's
responsibility to follow up with their insurance company and notify Simplified Restoration of any delays of said release date
in writing to avoid any late charges. Customer understands that the company has the right to file a claim on foreclosure,
a mechanic's lien and/or materials lien against the real properly upon which materials and/or labor is furnished for which
payment is not received. Customer represents that he/she has full authority to enter this agreement as a representative for the
legal owner(s) of the property. Customer agrees that this contract also functions as a mortgage upon that property which shall
secure the amounts owed under this contract and may be filed at any time by Simplified Restoration in any county. The
company may also supply the legal description or any other information necessary to perform its mortgage lien. Customer
is responsible to pay all legal tees and collection fees associated in regards to any and all debt owed to Simplified Restoration.
10. Customer further agrees that the equity in this property is security for this contract.
11. Non -Payment of any of the contractual amount (which would include approved supplements by the insurance company)
would void all warranties, discounts, guarantees or bonuses given to the customer at the time of signing this contract.
12. Simplified Restoration reserves the right of venue to litigate any collection issue or other issues that may arise.
13. Prior to litigating any dispute arising out of this agreement, customer agrees to mediate and/or arbitrate said dispute through
the dispute resolution program offered by the BBB Serving Denver/Boulder(BBB). By agreeing to submit any dispute arising
out of this agreement, customer agrees that no dispute arising out of this agreement, customer agrees that no dispute
shall be submitted to arbitration prior to the exhaustion of informal grievance procedures traditionally used by the BBB.
Customer furthermore understands that the arbitrator's decision is legally binding on all involved in the dispute.
CANCELLATIONS, BREACH OF CONTRACT POLICIES I Customer Initial
14. Breach of Contract - Purchaser agrees to pay company an amount of (20%) of the fol ce written on the front
of contract should purchaser cancel (his contract or not allow work to commence for any reason. Breach of Contract atter work
has commenced- Customer agrees to provide final insurance approved scope of work. Failure to share or cooperate in
the supplemental process by not providing final approved insurance scope of work from insurance company to Simplified
Restoration may result in Simplified Restoration building a'"Xactimate report on contracted project as well as any and
all supplemental items. In turn the "Xaclimate report that will be used is the one that is generated thru the Simplified
Restoration Office On three or more trades a (10%) overhead and (10%) profit, contractor fees, any and all permit fees
needed to get project legally completed will be applied to the "Xactimate Report. Customer agrees that they will be fully
responsible for the amount of money it lakes to complete project in accordance to the Simplified Restoration "Xactimate
Report. Customer also agrees that all bonuses associated to contrac(will be forfeited. "Xactimate is the computer
estimating program that is the recognized by most in the home owner insurance and insurance restoration business"
15 Customer has a right to rescind any part or all of contract within 72 hours of entering into this contract. If the customer
should choose to rescind contract within 72 hours, customer would receive a 100% refund for any monies he/she
had applied towards this contract. This 72 hour cancellation period also applies to any insurance claims that are
denied in part or in whole
16. To acceptably execute the cancellalion of this contract or any part of this contract, the Customer must give a written
notice
of cancellation by certified mail to Simplified Restoration, 2950 S. Jamaica Ct. Unit 306 Aurora, CO. 80014 or
deliver it in person to Simplified Restoration office or physically give the written notice to a representative of
Simplified Restoration
17. If customer does not rescind contract within the 72 hours provided , yet decides to cancel the contract customer would
then be held liable for the following Custom e uld be resp nsibleior (20%) of the contract price written on the
oaf of the contract If material is delivered, Omer w be responsible for a restocking fee of ($1000) dollars.
WARRANTY POLICY I Customer Initial
18. For entire root application (i.e new Installations) Simplified Restoration liability is limited to repairing the roof resulting
from worxrnanship or material application for a period of (10) years from the date of final Invoice from company. All other
projecls trial Simplified Restoration Is contracted to do by customer that Is not a roof, Simplified Restoration liability is
limited to repairing said project resulting from workmanship or material application for a period of (1) year from the date
of final invoice from company. All Warranties are transferable to one additional homeowner within the said time frame
of specific warranty. Simplified Restoration expressly excluded consequential damages to the building or contents and
subject to the conditions and limitations set forth in this warranty. Simplified Restoration shall be liable for actual damage
caused only by Simplified Restoration to the building. For partial root applications and partial repair work, Simplified Restoration
liability is limited to the root or any other partial repair project Simplified Restoration is contracted to do for a period of
(90) days from the date of completion. Customer expressly waives all other rights except those stated herein.
19. Labor warranty does not cover damage to roofing or any other projects customer has contracted with Simplified Restoration
caused by lightning, wind exceeding 50 mph., hurricanes, hailstorms, other violent storms, casually, impact of loreign
objects, failure to conduct regular homeowner maintenance, damage due to settlement or distortion, failure of foundation, or
cracking of the walls of the building. For roofing warranty only, Simplified Restoration is not responsible for any damage
to the interior of the building after installation and ing the warranty period.
GENERAL POLICIES I Customer Initia
20. Initial roof inspections for the purpose ofesb m are visual and non-destructive. Upon Commencement
of work, should the discovery that additional labor, time and/or material be required to obtain local compliance beyond
the scope of work or insurance approval, customer will be notified immediately in writing and will be responsible for these
additional costs by executing a "change order." This "change order" may or may not include a revised completion date.
The "change order" shall be signed by all parties.
21. Simplified Restoration a licensed and insured company. Simplified Restoration's policy is that anyone that works in a
sub -contractor capacity also holds liability insurance. Simplified Restoration is happy to provide customer with a copy
of our insurance. Our insurance Provider is DC Insurers. our policy number is 10005003000499 and can be contacted
at 303.693.9343.
22. In the case that this is an insurance restoration claim and customer intends to pay Simplified Restoration with insurance
proceeds, it is illegal for Simplified Restoration to pay, waive or rebate homeowner insurance deductible in part or in whole.
23. All contracts are subject to approval of the company's management.
24. All excess material is Simplified Restoration property unless otherwise noted on the contract. Simplified Restoration as
policy orders more than what is needed on most jobs in an effort to be more efficient.
25. Customer is responsible for home owner association approval for all color choices and product choices. Customer would
be responsible for replacement it color choices and product choices are not in concordance with his/her HOA. Simplified
Restoration will and cannot be held accountable forany charges associated with fines due to non-compliance with customers HOA.
26. Customer understands that this project will be a construction site. Customer understands that roofing debris such as lar
may hit the side of the house. Customer understands that if tar or anything else should get on the side of the house that
Simplified Restoration is only responsible for getting that mark off of the house and touching up that area only. Customer
understands the touch up may not match completely with the house due to normal wear and tear of structure.
27. Customer is responsible for everything inside of the house, including artwork, anything valuable or anything that may fall off a
wall or table.
28. Customer is responsible for moving anything of value away from house that he/she may not want to possible be hit by
falling roofing debris.
29. If customer has satellite dish on roof. Simplified Restoration is only responsible for removing and resetting satellite dish.
We are not responsible for getting correct signal. If customer wants the satellite repositioned, he/she is responsible to get
Satellite Company out to regain signal or he/she can have Simplified Restoration Satellite guy come out and reposition the
satellite dish. Customer knowingly knows and accepts that he/she may not have satellite service for an extended amount of time.
30. Simplified Restoration is not responsible for vegetation or plants around the house. Customer is responsible for covering
anything it does not want walked on or falling debris hitting.
31. As the undersigned. I waive all rights and claims against simplified Restoration for the use of, and any corresponding
damage to, curb and drive -ways as a means of access for trucks and equipment in the execution of work.
32. Customer agrees with and is fully aware that Simplified Restoration does not control or know any venders schedule as
to when material will be delivered. By signing this contract Customer is allowing any vender that Simplified Restoration
uses to drop off material. Failure to allow vender to drop off material may result in a breach of contract and may result in
any penalties or fees associated to breach of contract.
33. The company will not be held responsible for slight scratching or denting of gutters, ail droplets in the driveways, cracks
in concrete or damage to plants and trees. Furthermore, the company will not be held responsible for exterior damages
such as broken or fallen crown molding or stucco, deteriorated solar panels, evaporative coolers and existing skylights
or any interior damage such as falling dust and debris as a result of re -rooting, cracked plaster, sheetrock and nail pops.
34. This contract both front and back and all corresponding contracts such as the roofing, siding, gutters, window etc.
constitutes the entire understanding of the parties, and no other understanding, collateral or otherwise, shall be binding
unless in writing and signed by both parties.
36. The company is not responsible for damage to hidden Freon, alarm, telephone, or electrical linesnless these items have
to be manipulated to do the contracted project.
37. Property owner and the property owners insurance is to remain in effect and to indemnify and hold harmless The Company
for any incidental damages incurred prior to, during and after the work in progress to coincide with the company warranty.
38. Company shall not be held responsible or liable for any damages occurring due to placement of materials or property by
anyone other than the company.
39. During the roofing, siding, gutter, painting etc. process some vibrations may occur. The customer must take the necessary
precautions to prevent picture, fixtures and/or other items from falling and breaking within the interior and/or dust within
the interior or exterior of the building.
40. Company may, at its own discretion, engage subcontractors, and in all instances ensure the proper completion of this contract.
41. Customer hereby acknowledges that company may be subject to delays occasioned by inclement weather, labor disputes,
material supply shortages, contractor scheduling or issues with vendors that are beyond the control of Simplified Restoration.
Customer hereby acknowledges that all such delays do not constitute abandonment and are not included in calculating
time frames for payment and performance of contracted project. At no lime shall any of these acceptable delays in
contracted project constitute a refund i count of the contract price owed to Simplified Restoration.
EXCLUSIONS I Customerinitial
• No Repairs to the roof drains, plumbing system, heating and cooling systems, and/ or replacement of fascia boards,
ventilators, flashing, roof jacks, or material and/or repairs to the building or work preparatory to the application of the
company's work is included in this contract unless such items are specifically stated in writing.
• Customer understands and accepts that everything must be written on the contract to be done. If it is not written on the
contract, Simplified Restoration is not responsible for doing project.
• This document, when accepted by the customer, will constitute the entire agreement between the parties hereto, there
being no promises or agreements written or oral except for the provisions herein set forth. By signing this contract,
Is and agrees that this is �Iegal and binding contract.
Permission to use y roperty wit n Slified Restoration's printed and online marketing promotions.
UST ME DAT
SIGNATURE OF SIMPLIFIED RE,TORATIOrJ REPRESENTATIVE DATE
INSPECTION RECORD
Inspection online form: http://www.ci.wheatridge.co.us/inspection
Cancellations must be submitted via the online form before 8 a.m. the day of the inspection
Inspections will not be performed unless this card is posted on the project site
Request an inspection before MIDNIGHT (11:59 PM) to receive an inspection the following business day
PERMIT: 2xil kl,'7 ADDRESS: JOB CODE:
Foundation Inspections
Date
Inspector
Initials
Comments
102 Caissons / Piers
103 Footing / P.E. Letter
104 Foundation Setback Cert.
105 Stem Walls
106 Foundation wall Insulation
Do Not Pour Concrete Prior To Approval Of The Above Inspections
Underground / Slab Inspections
Date
Inspector
Initials
Comments
201 Electrical / Cable/ Conduit
202 Sewer Underground Int.
203 Sewer Underground Ext.
204 Plumbing Underground Int.
205 Plumbing Underground Ext.
206 Water Underground
1LfL ( S
Do Not Cover Underground or Below / In -Slab Work Prior To Approval Of The Above Inspections
Rough Inspection
Date
Inspector
Initials
Comments
301 Rough Framing
302 Wall Sheathing
303 Roof Sheathing
304 Sheer Inspection
305 Insulation
306 Mid -Roof
1LfL ( S
307 Metal / Lath / Stucco
308 Rough Electrical Residential
309 Rough Electrical Commercial
310 Electrical Meter Residential
311 Electrical Meter Commercial
312 Temp. Const. Meter
313 Rough Plumbing Residential
314 Rough Plumbing Commercial
315 Shower Pan
SEE OVER FOR ADDITIONAL INSPECTIONS
PERMIT: ADDRESS: lD J�.IJ YV. p i � 1 JOB CODE:
Rough Inspection (continued)
Date
Inspector
Initials
Comments
316 Rough Mechanical Residential
317 Rough Mechanical Commercial
318 Boiler / Furnace
319 Hot water tank
320 Drywall screw and Nail
321 Moisture board / shower walls
322 Rough Grading
323 Miscellaneous
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Final Inspections
Date
Inspector
Initials
Comments
402 Gas Meter Release
403 Final Electrical Residential
404 Final Electrical Commercial
405 Final Mechanical Residential
406 Final Mechanical Commercial
407 Final Plumbing Residential
408 Final Plumbing Commercial
409 Final Roof
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410 Final Window/Door
411 Landscape/Park/Planning*
Inspections from these entities shall be requested
one week in advance.
*For landscaping and parking inspections please
call 303-235-2846
"For ROW and drainage inspections please call
303-235-2861
***For fire inspections please contact the Fire
Protection District for your project.
412 Row/Drainage/Public Works**
413 Flood plain Inspection**
414 Fire Insp. / Fire Protection***
415 Public Works Final**
416 Storm Water Mgmt.**
417 Zoning Final Inspection*
418 Building Final Inspection
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 by the Fire District and
Electrical low voltage by the Building Division.
Property Address
Permit Number
Permit Issued Date
The City of Wheat Ridge
Third Party Form Check List
: �)0171
_e -F3 .
Owner Information
Property Owner Information
Property Owner Address
Inspection Company
Inspector Name
Inspector Contact info.
fi, //kI/ e6G L e;I
,S-? S z- A-1 �e%f -f-f"
Inspector Statement and Acknowledgement
* I hearby acknowledge the roof I am inspecting is 6/12 or over all roofs
that are under 6/12 must be inspected by the City of Wheat Ridge Buiding Dept.
* I hearby acknowledge the roofing system for the referenced building has been inspected
and found to be in compliance with the minimum requirements of the 2012 IRC and 2012
IBC as well as all City of Wheat Ridge Policies and Procedure and Manufacturer's
recommendation an do
Inspector: ' Date: ��
Pro rt Owner Statement of Acknowledgement
*1 hearby acknowledge that5Ri
the o ner of the building referenced above and I give
my consent for the listed tat
party, i spection company to perform my roof in pect'on
in lieu of the Cit of Wheat Ud i D'vision ins ection.
Propery Owner/ Agent: `� p Date: ��
This original document as well a the&- oofing check list, must be submitted to the Chief
Building Offical within seven days of the final inspection.
Drop off in person Submit via Email
Permit counter 2nd floor cookci wheatrid e,co.us
7500 W. 29th Ave
Wheat Ridge CO 80033
Drafted Date: 7/26/17
Please add note to reverse side
The City of Wheat Ridge
Inspection Check List Notes
Mid -Roof
Roof Inspection
❑ N/APass ❑ Fail Structural roof components
❑ N/A Pass ❑ Fail Verify that no more than 2 layers of shingles exist
❑ N/A Pass ❑ Fail Flashing for roof and walls
N/A ❑ Pass ❑ Fail If new sheathing is installed, verify that it is listed in the permit
description (Valuation must be adjusted)
OX N/A ❑ Pass ❑ Fail Verify sheathing nail pattern (see Policy and Procedures)
YN/A ❑ Pass ❑ Fail Crickets and saddles where needed
❑ N/APass ❑ Fail Verify vent must have boot same gauge as pipe
❑ N/A _ Pass ❑ Fail Verify vent caps
❑ N/A Pass ❑ Fail Verify no flashings are damaged or rusted
❑ N/A Pass ❑ Fail Step flashing shall be min. of 44 piece per shingle
❑ N/A Pass ❑ Fail Verify scuppers allow for proper drainage
❑ N/A Pass ❑ Fail Ice and water shield 2' in heated wall spaces
❑ N/A Pass ❑ Fail Underlayments must follow 2012 1RC/2012 IBC
❑ N/A Pass ❑ Fail Verify roof slope for proper damage
❑ N/A I Pass ❑ Fail Dripedge shall have min. of 2" overlap
❑ N/A Pass ❑ Fail Dripedge should extend down min. 2" past roof deck
❑ N/A Pass ❑ Fail Dripedge shall be mechanically fastened 12" OC
N/A ❑ Pass ❑ Fail 90 LB roof roofing shall not be applied to roof slopes less than
2:12 slope. Exception, detached garages, patios, carports, open
on three sides with min. slope of 1:12
N/A ❑ Pass ❑ Fail Above roof insulation R-25
N/A ❑ Pass ❑ Fail Below roof residential R-38
N/A ❑ Pass ❑ Fail Below roof commercial R-32
N/A ❑ Pass ❑ Fail Modified Bitumen, EPDM, TPO min. slope 1/4:12 slope must be
installed in accordance with the manufacturer's specifications.
Must have manufacturer's letter of warranty with the address
on the letter for final inspection
Metal Roof Shingles Requirements
N/A ❑ Pass ❑ Fail Metal roof shingles shall not be installed on slope less than 3:12
N/A ❑ Pass ❑ Fail Metal valley flashing shall be the same material as roof
N/A ❑ Pass ❑ Fail Metal valley flashing shall extend a min. of 8" from the
centerline with a min. of 3/4 " high splash diverter rib built-in at
the flow line with the sections overlapping a min. of 4"
Tile Roof Requirements
N/A ❑ Pass ❑ Fail Clay and concrete tile shall have a min. 2-1/2:12 slope
N/A ❑ Pass ❑ Fail Slopes 4:12 and under require double underlayment
CBC Wheat Ridge Roof Inspection Packet Page 3 of
6
The City of Wheat Ridge
Inspection Check List Notes
Mid -Roof
Notes
Company Name:
Inspector Signature:
Date of Inspection:
CBC Wheat Ridge Roof Inspection Packet Page 4 of
6
The City of Wheat Ridge
Inspection Check List Notes
Final Roof
Roof Inspection
❑ N/A
V, Pass
❑
Fail
Structural roof components
❑ N/A
Pass
❑
Fail
Verify that no more than 2 layers of shingles exist
❑ N/A
Pass
❑
Fail
Flashing for roof and walls
❑ N/A
Pass
❑
Fail
Structural roof components
N/A
❑ Pass
❑
Fail
If new sheathing is installed verify that it is listed in the
permit description (Valuation must be adjusted)
N/A
❑ Pass
❑
Fail
Verify sheathing nail pattern (See Policy and Procedures)
N/A
❑ Pass
❑
Fail
Crickets and saddles where needed
❑ N/A
)d Pass
❑
Fail
Verify B vent must have boot same gauge as pipe
❑ N/A
A� Pass
❑
Fail
Verify vent caps
❑ N/A
A Pass
❑
Fail
Verify no flashings are damaged or rusted
❑ N/A
Pass
❑
Fail
Step flashing shall be min. of 44 piece per shingle
❑ N/A
Pass
❑
Fail
Verify scuppers allow for proper drainage
❑ N/A
Pass
❑
Fail
Ice and water shield 2' in heated wall spaces
❑ N/A
Pass
❑
Fail
Underlayments must follow 2012 IRC/2012 IBC
❑ N/A
Pass
❑
Fail
Verify roof slope for proper drainage
❑ N/A
Pass
❑
Fail
Dripedge shall have min. 2" of overlap
❑ N/A
Pass
❑
Fail
Dripedge should extend down min. 2" past roof deck
❑ N/A
Pass
❑
Fail
Dripedge shall be mechanically fastened 12" OC
N/A
❑ Pass
❑
Fail
90 LB roll roofing shall not be applied to roof slopes less than
2:12 slope: Exception, detached garages, patios, carports, open
on three sides with min. slope of 1:12
N/A
❑ Pass
❑
Fail
Modified Bitumen, EPDM, TPO min. slope 1/4:12 slope must be
installed in accordance with the manufacturer's letter of
warranty with the address on the letter for final inspection
Metal Roof Shingles
Requirements
YN/A ❑ Pass ❑ Fail Metal roof shingles shall not be installed on slope less than 3:12
XN/A ❑ Pass ❑ Fail Metal valley flashing shall be the same material as roof
)q N/A ❑ Pass ❑ Fail Metal valley flashing shall extend a min. of 8" from the
/' centerline with a min. of 3/4 " high splash diverter rib built-in at
the flow line with the sections overlapping a min. of 4"
Tile Roof Requirements
N/A ❑ Pass ❑ Fail Clay and concrete tile shall have a min. 2-1/2:12 slope
N/A ❑ Pass ❑ Fail Slopes 4:12 and under require double underlayment
CBC Wheat Ridge Roof Inspection Packet Page 5 of
6
Company Name:
Inspector Signature:
Date of Inspection:
The City of Wheat Ridge
Inspection Check List Notes
Final Roof
Notes
Certified Buoding Consultants
CBC Wheat Ridge Roof Inspection Packet Page 6 of
6
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