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HomeMy WebLinkAbout12300 W. 49th PlaceCity of /���Wheat� ge BUSINESS LICENSE INSPECTION PERMIT NO. 20210240 SC INSPECTION DAY/TIME Thursday, 02/28/21 @ 10:00 AM INSPECTION DAY/TIME INSPECTION DAY/TI BUSINESS NAME: Clllessen Construction Company ADDRESS: 12300 W. 49th PI., Unit 2 CONTACT NAME: Pam Lockwood (303)-305-7001 offiu[ bou yoSQ FT L I OCCUPANCY TYPE OCCUPANCYLOAD 3A- 1 CONSTRUCTION TYPE ❑ SPRINKLERED POON-SPRINKLERED ,' — Inspector Signature 2.- Date CERTIFICATE OF OCCUPANCY Permit #: 202100240 � A� Wheatpjd eg COMMUNITY DEVELOPMENT 7500 W 29TH AVE WHEAT RIDGE CO 80033-8001 Stipulations: Cillessen Construction Company Date: 02/19/2021 This certificate verifies that the building constructed and/or the use proposed of the building and/or premises, under the above permit number and on property described below, does comply with the Wheat Ridge Building Code, Zoning and other related land use and development laws of the City of Wheat Ridge, and may be occupied for the use specified. OWNER: S H O P PROPERTIES ADDRESS: 13020 W 58th Ave, Arvada, CO 80002 CONTRACTOR/ADDRESS: PROPERTY ADDRESS: 12300 W 49th P1 Unit 2, Wheat Ridge, CO 80033 PARCEL #: 39-174-07-003 ZONING: I -E OCCUPANCY: B TYPE OF CONST: III -A OCC LOAD: 7 FOR THE FOLLOWING PURPOSE: Bus. License Report Code Editions: N/A No change shall be made in the Use of this building without prior notice and a new CERTIFICATE OF OCCUPANCY from the City of Wheat Ridge Certificate MUST be posted by front door of commercial occupancies Chief Building Official Zoning Administrator Sprinklered: No Inspection Type: Job Address: Permit Number: CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE j No one available for inspection: Time AM/PM Re -Inspection required: Yes No When corrections are complete, schedule re -inspection online. Date: Inspector: DO NOT REMOVE THIS NOTICE 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: Job Address:' Permit Number: _ N ❑ No one available for inspecti n Time AWPM ./ Re -Inspection required: Yes ._No When corrections have been made, call for re -inspection at 303-234-5933 Date:',' Inspector: DO NOT REMOVE THIS NOTICE 44" City of Wheat Ridge _A� Commercial Mechanical PERMIT - 202100027 PERMIT NO: 202100027 ISSUED: 01/06/2021 JOB ADDRESS: 12300 W 49th Pl EXPIRES: 01/06/2022 JOB DESCRIPTION: Replace 80K BTU, 80% eff gas furnace in utility room *** CONTACTS *** OWNER (303)884-6056 CILLESSEN JOHN SUB (720)301-3914 JOHN DEMERECKIS 070151 PARADISE HEATING & COOLING *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 420 / Storage Warehouse; 0 BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 21760.00 FEES Total Valuation 0.00 Use Tax 57.96 Permit Fee 93.35 ** TOTAL ** 151.31 *** COMMENTS *** *** CONDITIONS *** Both the front and back of this permit are required to be posted on the job site at all times. If the complete permit is not present, inspections WILL NOT be performed. Work shall comply with 2018 IRC & 2020 NEC. Smoke alarms shall comply with 2018 IRC Section 134. Interior alterations, repairs, fuel -fired appliance replacements, or additions, any of which require a building permit, occurs or where one or more rooms lawfully used for sleeping purposes shall have an operational carbon monoxide alarm installed within fifteen feet of the entrance to each room lawfully used for sleeping purposes. 1* � 4 41' PERMIT NO: JOB ADDRESS: JOB DESCRIPTION: City of Wheat Ridge Commercial Mechanical PERMIT - 202100027 202100027 12300 W 49th Pl Replace 80K BTU, ISSUED: EXPIRES: 80% eff gas furnace in utility room 01/06/2021 01/06/2022 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�permrt. I further attest that I am leg ally authorized to include all entities named within this document as parties to the work to be performed and that all work to be performed is disclosed in this document and/or 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 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 requ�ired 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, anviolation 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 Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. From: no-reolv(alci.wheatridae.m. us To: CommDev Pets Subject: Online Form Submittal: Furnace/Boiler Replacement Permit Application Date: Wednesday, January 6, 2021 1:32:06 PM Furnace/Boiler Replacement Permit Application This application is exclusively for RESIDENTIAL REPLACEMENT FURNACE or BOILER - LIKE FOR LIKE ONLY. YOU MUST ATTACH A VALID CREDIT CARD AUTHORIZATION FORM IN ORDER FOR THE PERMIT TO BE PROCESSED. Your Permit will be emailed to the email address provided below once it is processed. THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN WORK UNTIL PERMIT HAS BEEN ISSUED. Is this application for a Yes replacement residential furnace or boiler like for like? WKi],A36'd1010]VrLTiIG\1 ffl0 Is this Residential or Commercial Commercial? Property Address 12300 W 49th PI Wheat Ridge, CO 80033 Property Owner Name John Cillessen Property Owner Phone (303) 884-6056 Number (enter WITH dashes, eg 303-123- 4567) Property Owner Email jcillessen@aol.com Address Attach City of Wheat Electronic Payment Form - Revised 5-1-20 Ridge Electronic Fillable 202005011620013849 202006081141368198 (1).odf Payment Form - "DO NOT ATTACH A PICTURE OF A CREDIT CARD" CONTRACTOR INFORMATION Contractor Business Paradise Heating and Cooling Name Contractor's License 070151 Number (This is a 5 or 6 digit number for the City of Wheat Ridge) Contractor Phone 720-301-3914 Number (enter WITH dashes, eg 303-123- 4567) Contractor Email office@paradiseheatingandcooling.com Address Retype Contractor office@paradiseheatingandcooling.com Email Address DESCRIPTION OF WORK What type of unit is Furnace being installed? Number of BTUs 80000 What is the efficiency 80 (%) of the unit? Is the unit GAS or GAS ELECTRIC? Where is the furnace or Utility room boiler located (for example, basement, crawlspace, etc)? Project Value (contract 2760 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 John Demereckis Permit Email not displaying correctly? View it in your browser. i CITY OF WHEAT RIDGE Building Inspection Division (303) 235-2855 Office INSPECTION NOTICE Inspection Type: :47- / A. Job Address: 10- Permit 0-Permit Number: /9�-:) z ❑ No one available for inspection: Time 4-02 Re -Inspection required: Ye No When corrections have been made, schedule for re -inspection online at: h Up ✓/www. ci. wheatridge. co. usfinspection Date: / R j' Inspector: VD0 NOT REMOVE THIS NOTICE 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: `�'� 1-0"7*- Job Address: Permit Number: I No one available for inspection: Time M I le -Inspection required: Yes �No When corrections have been made, call for re -inspection at 303-234-5933 ►ate: - Inspector:- DO NOT NOT REMOVE THIS NOTICE 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: F , t Job Address: Permit Number:, -2) U L 0 q o,3 Irc�t> \- 2\451'( t,, 1� V -)(J Ck(. C c:. % O c r . irk\1��C 1�f1�`-r��.\.(��,(t✓Z i���1��.d �..•:[;,�. ❑ No one available for inspection: Time L' A/PM Re -Inspection required: Y66� No When corrections have been made, call for re -inspection at 303-234-5933 Date: Inspector: DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division r. (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: M (111) _ _PC1X_)1:�__ Job Address: (22 -fn Q 49 tlE` Pt Permit Number: f_'� (� 02 c.k'),3 ❑ No one available for inspection: _Time A Re -Inspection required: Yes/No�� When corrections have been made, call for re -inspection at 303 -234 - Date:— 1, S Inspector: DO NOT REMOVE THIS NOTICE I* � 4 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: "FI� Qw- Job Address: Permit Number: ❑ No one available for inspection: Time AM/PM Re -Inspection required: Yes No When corrections have been made, call for re -inspection at 303-234-5933 Date: q `'{/ Inspector: DO NOT REMOVE THIS NOTICE City of Wheat Ridge Commercial Roofing PERMIT - 201802403 PERMIT NO: 201802403 ISSUED: 08/30/2018 JOB ADDRESS: 12300 W 49th P1 EXPIRES: 08/30/2019 JOB DESCRIPTION: Install new PBR or R -panels over existing with roof hugger system; Install ISO; new shingles - 4 squares; install underlayment; 70 squares *** CONTACTS *** OWNER (303)808-1048 S H O P PROPERTIES LLC SUB (303)296-0361 Randy Brothers/Cody Hayes 130240 Elite Roofing *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 420 / Storage Warehouse; 0 BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 76,969.25 FEES Total Valuation 0.00 Use Tax 1,616.35 Permit Fee 946.90 ** TOTAL ** 2,563.25 *** COMMENTS *** *** CONDITIONS *** In order to pass a final inspection on commercial elastomeric or similar type roofing, 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. 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 -roof inspections may be called in at the same time, 100 percent of the sheathing must be complete and 25-75 percent of the midroof may be complete. Asphalt shingles are required to be fastened to the roof deck with a minimum of 6 nails per shingle. 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. City of Wheat Ridge Commercial Roofing PERMIT - 201802403 PERMIT NO: 201802403 ISSUED: 08/30/2018 JOB ADDRESS: 12300 W 49th P1 EXPIRES: 08/30/2019 JOB DESCRIPTION: Install new PBR or R -panels over existing with roof hugger system; Install ISO; new shingles - 4 squares; install underlayment; 70 squares I, by in 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 an uthorized to obtain this permit and perform the work described and approved in conjunction with this permit. I further attest that I a eggally uthorized to include alI entities named within this document as parties to the work to be performed and that all work to b ertormed is disclosed in this document and/or its' a companying approved plans and specifications. Signature of OWNER or CO1N4FbVCTOR (Circle one) Date 1 I . This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. 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 androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a changeof the natural flow of water without prior and specific approval. 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, an violation of any provision of any applicable � or any ordinlice or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. City of Wheat jdge COMMUNITY DEVELOPMENT Building & Inspection Services Division 7500 W. 2911 Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: permits anci.wheatridge.co.us FOR OFFICE USE ONLY Date: l.U( Plan/Permit # Plan Review Fee: Building Permit Application *** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: /,i �5 (.1), q q f6 ?/ Property Owner (please print): 01, J 16.5,54 Property Owner Email: in a 0 1 - C-0 VY 3_,0321 - Tenant (Commercial Projects Only) (� N j e_250 0 a451v-a Property Owner Mailing Address: (if different than property address) Address: City, State, Zip: Arch e y' Architect/Engineer E-mail: Contractor: 1 �nc_' �l V) City of Wheat Ridge License #: Contractor E-mail Add (�0 '_�? 0 Phone: Phone: .3U� -,-), q & — 0 3( - r'ov 1`,5 , C -o trY) For Plan Review Questions & Comments (please print): CONTACT NAME lease print): �Ci.�') � 0� 5 Phone: CONTACT EMAIL(please print):_ _ C1 Ct- U it G1 C_' -I t �e' rcc S : 0_"5' G'yq Sub Contractors (Must provide Wheat Ridge License No.): Electrical: Plumbing: Mechanical: W.R. City License # W.R. City License # W.R. City License # Other City Licensed Sub: Other City Licensed Sub: City License # City License # COMMERCIAL F1 RESIDENTIAL Description of work: For ALL projects, provide a detailed description of work to be performed, including current use of areas, proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc. 4 e rev u-ig' 9 r 5y stcr �T,140-fl -5�J o.� �► � �Q-1( UAJ, e r /ay vYl e rl �� 6L+ S�1 Commercial Projects Only: Occupancy Type: Sq. FULF BTUs Amps Squares / r) Construction Type: Gallons Project Value: (Contract value or the cost of all materials and labor included in the entire project) $ `/ , OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any entity included on this application to list that entity on this application. I, the applicant for this building permit application, warrant the truthfulness of the information provided on the application. CIRCLE ONE: Si natu� Printed of (OWNER) (CONTRACTOR) kTE: 9-0,7-1 ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: PUBLIC WORKS COMMENTS: Reviewer: DEPARTMENT USE ONI " OCCUPANCY CLASSIFICATION: CONSTRUCTION TYPE: Building Division Valuation: i CITY OF WHEAT RIDGE �(303) Building Inspection Division (303) 234-5933 Inspection line 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Job Address: Permit Number: ❑ No one available for inspectiom-,Ti AM/PM Re -Inspection required: Yes When corrections have been made, call for re-ibspection at 303-234-5933 ('Inspector; City of Wheat Ridge Residential Electric PERMIT - 201802160 PERMIT NO: 201802160 ISSUED: 08/02/2018 JOB ADDRESS: 12300 W 49th P1 EXPIRES: 08/02/2019 JOB DESCRIPTION: Residential electric: new 200 AMP 3 phase electrical service to replace existing 100 AMP new interior sub -panel. *** CONTACTS *** OWNER (303)808-1048 CILLESSEN JOHN SUB (303)263-8068 Michael Sprankle 170671 Modern Electric LLC *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 420 / Storage Warehouse; 0 BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 4,500.00 FEES Total Valuation 0.00 Use Tax 94.50 Permit Fee 125.05 ** TOTAL ** 219.55 *** COMMENTS *** *** CONDITIONS *** Must comply w/ 2012 IRC & 2017 NEC. 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 erm1 1 further attest that I am legally authorized to include all entities named within this document as parties to the work to be performed and that all work tobeper0rmeisdislsein this document and/or 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 permit fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4, No work of any manner shall be performed that shall results in a changeof the natural flow of water without prior and specific approval. 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 Divi 6. The s nce r grantof a permit shall not be construed to be a permit for, or an approval of, an violation of any provision of any ap or a or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of CVWe Official Date REQUESTS MUS BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPE ION THE FOLLOWING BUSINESS DAY. �Wh6atPd eR�GIVi MUNITY DEVELOPMENT AUG 0 2 Mi Building & Inspection Services Division 7500 W. 291' Ave., Wheat Ridge, CO 80033 per Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: permits(@ci.wheatridge.co.us FOR OFFICE USE ONLY Date: Plan/Permit # Plan Review ee: Building Permit Application *** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: / Z31 L" Property GL� `��7 PL Property Owner (please print): :3-0 =L (_�=S5(� Phone: ` ex? 8"D13- 1O4� Property Owner Email: heath 4✓ Ci ile55cl) Com Tenant (Commercial Projects Only) CL L L c - 55t5'-.1 Co n, i /zyc r27d"/ Property Owner Mailing Address: (if different than property address) Address: City, State, Zip: GJ Architect/Engineer E-mail: Phone: Contractor Name:�71&y� u C - City of Wheat Ridge License #: / Unto 2 1 Phone: ?'� 3 2_&Foee T 1 / Contractor E-mail Address: \I ciSan 6)�c/(- For Plan Review Questions & Comments (please print):: G CONTACT NAME (please print): �4-s©a� / V = �,5 Phone: .'c>3 3� CONTACT EMAIL(please print): Sub Contractors (Must provide Wheat Ridge License No.): Electrical: Plumbing: Mechanical: W.R. City License # W.R. City License # W.R. City License # Other City Licensed Sub: Other City Licensed Sub: City License # City License # COMMERCIAL ❑ RESIDENTIAL Description of work: For ALL projects, provide a detailed description of work to be performed, including current use of areas, proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc. Sq. FULF ?,a) 4 P 1+4 S l= %tet, r-- c-Trz-x-c L. Sr�✓�� , rc7 E F,xzs; r"JG IZo �J Iiz-�2 S 3 ?A-PJe— - BTUs Amps --Z-O O Squares Gallons Commercial Projects Only: Occupancy Type: Construction Type: Occupancy Load: I Project Value: (Contract value or the cost of all materials and labor included in the entire project) $ C I 7S� OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any entity included on this application to list that entity on this application. I, the applicant for this building permit application, warrant the truthfulness of the information provided on the application. CIRCLE O E: (OWNER) CONTRAC _ IZED EPRESENTATIVE) of (OWNER) (CONTRACTOR) Signature (first and last name): - DATE: '51— Z �� Printed Name: ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: PUBLIC WORKS COMMENTS: Reviewer: DEPARTMENT USE ONLY OCCUPANCY CLASSIFICATION: CONSTRUCTION TYPE: Building Division Valuation: 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: 31 / F—M 6— /,/, q F Job Address: 1 E D 0 1,V f L Permit Number: 1�0/ 00 d_l6 0 ❑ No one available for inspection: Time AM/PM Re -Inspection required:6;) No When corrections have been made, call for re -inspection at 303-234-5933 Date: ghg/ Inspector: DO NOT REMOVE THIS NOTICE