HomeMy WebLinkAbout4965 Independence Street44" City of Wheat Ridge
_A� Commercial Plumbing PERMIT - 202002690
PERMIT NO: 202002690 ISSUED: 12/29/2020
JOB ADDRESS: 4965 Independence St EXPIRES: 12/29/2021
JOB DESCRIPTION: Installing 1 1/2 back flow in grass.
*** CONTACTS ***
OWNER (303)880-1628
CLEAVER LAUREN V
SUB (3 03) 726 -3888
JOEL VERBECK
170268 MILE HIGH
DRAIN CLEANING INC.
*** PARCEL INFO ***
ZONE CODE:
UA / Unassigned
USE:
UA / Unassigned
SUBDIVISION CODE:
420 / Storage Warehouse; 0
BLOCK/LOT#:
/
*** FEE SUMMARY *** ESTIMATED
PROJECT VALUATION:
71221.22
FEES
Total Valuation
0.00
Use Tax
151.65
Permit Fee
172.60
** TOTAL **
324.25
*** COMMENTS ***
*** CONDITIONS ***
A printed copy of the permit and city stamped on-site plans must be available on-site for
the first inspection.
Approved per plans and red -line notes on plans. Must comply with 2018 IBC, 2020 NEC and all
applicable City of Wheat Ridge Municipal Codes. Work is subject to field inspections.
**Prior to final inspection approval - As-builts are required before approval of the
Building Final Inspection and Certificate of Occupancy can be issued.
1* � 4 41'
PERMIT NO:
JOB ADDRESS:
JOB DESCRIPTION:
City of Wheat Ridge
Commercial Plumbing PERMIT - 202002690
202002690 ISSUED:
4965 Independence St EXPIRES:
Installing l 1/2 back flow in grass.
12/29/2020
12/29/2021
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(alai.wheatridae.m. us
To: CommDev Pets
Subject: Online Form Submittal: Revision to Permit Application
Date: Monday, January 4, 2021 10:35:44 AM
Revision to Permit Application
Permit Number 202002690
assigned to project
PROPERTY INFORMATION
Permit Number 202002690
Property Address
Property Owner Name
Property Owner Phone
Number (enter WITH
dashes, eg 303-123-
4567)
4965 Independence St
Lauren Cleaver
303-880-1628
Property Owner Email Field not completed.
Address
CONTRACTOR INFORMATION
Contact Name Mile High Drain Cleaning, Inc
Contact Phone Number
(enter WITH dashes,
eg 303-123-4567)
Com@ a FRI91inw-ArGRm
303-726-3888
christina@milehighdrain.com
Retype Contact Email christina@milehighdrain.com
Address
DESCRIPTION OF WORK
Detailed Revised
Scope of Work -
Provide a detailed
description of the
change in scope of
work including
mechanical, electrical,
plumbing work
occurring,
The only item change being made to the original permit is the
address change. The address where work is being performed is
at 4965 Independence St.
adding/removing walls,
etc
Engineer Letter (if
applicable)
Additional Documents
on Letter Size
Are plans or
documents locked for
editing?
Construction Plans
scanned on 11'x17" or
larger
Additional Project
Value Only add what
the revised scope of
work is valued at.
Attach City of Wheat
Ridge Electronic
Payment Form - "DO
NOT ATTACH A
PICTURE OF A
CREDIT CARD"
Field not completed.
Field not completed.
No plans needed
Field not completed.
0
Electronic Payment Form WHEATRIDGE.odf
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 Submitting Christina Bailey
Revision
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