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Home My WebLink About4540 Teller StreetINSPECTION RECORD INSPECTION ONLINE FORM: http://www.ci.wheatridge.co.us/inspection INSPECTION REQUEST LINE: (303) 234-5933 Cancellations must be submitted via the online form before 8 a.m. the day of the inspection Occupancy/Type Inspections will not be performed unless this card is posted on the project site, **Request an inspection before 11:59 p.m. (midnight) to receive an inspection the following business day.** Inspector Must Sign ALL Spaces pertinent to this project Foundation Inspections Date Inspector Comments Initials Pier Sewer Service Concrete Encased Ground (CEG) Plumbing Foundation / P.E. Letter Mid -Roof Do Not Pour Concrete Prior To Approval Of The Above Inspections Underground/Slab Inspections Date Inspector Initials Comments Electrical Comments Sewer Service Plumbing 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. Do Not Cover Underground or Below/In-Slab Work Prior To Approval Of The Above Inspections Rough Inspections Date Inspector Initials Comments Wall Sheathing Inspections from these entities should be requested one week in advance. For landscaping and parking inspections call 303-235-2846. For ROW and drainage inspections call 303-235-2861. For fire inspections contact the Fire Protection District for your project. Mid -Roof '7 Floodplain Inspection (if applicable) Lath / Wall Tie Fire Inspection / Fire Protection Dist. Rough Electric Final Electrical Rough Plumbing/Gas Line Final Plumbing _ Rough Mechanical Final MechanicalC710 Rough Framing Roof Rough Grading Final Window/Doors Insulation Final Building Drywall Screw/ Nail 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. 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 oi-y I'5, (iL Final MechanicalC710 COM PGC C7 Roof /p - Final Window/Doors LC40 1/'/ Final Building /f C ✓&V -CT 0 / NOTE. All items must be completed and approved by Planning, Public Works, Fire and Building before a Certificate of Occupancy is issued. Approval of the Final Building inspection does not constitute authorization of occupancy. *For low voltage permits - Please be sure that rough inspections are completed from the Fire District and electrical low voltage by the Building Division. Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued Protect This Card From The Weather �w4 4 - PERMIT NO: JOB ADDRESS: JOB DESCRIPTION W. City of Wheat Ridge Residential Roofing PERMIT - 201705021 201705021 ISSUED: 07/28/2017 4540 Teller ST EXPIRES: 07/28/2018 Residential Re -roof to install OC TruDefinition Duration Storm IR4 asphalt shingles with 32sq remove asphalt shingles and install asphalt shingles pitch 5/12 *** CONTACTS *** OWNER (303)421-8454 DAVEY RICHARD A SUB (303)274-1111 Manuel Rocha 021129 Horn Brothers Roofing *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 8,919.00 FEES Total Valuation 0.00 Use Tax 187.30 Permit Fee 188.45 ** TOTAL ** 375.75 *** COMMENTS *** *** CONDITIONS *** Effective December 1, 2014, asphalt shingle installations require an approved midroof inspection, conducted when 25-75 percent of the roof covering is installed, prior to final approval. Installation of roof sheathing (new or overlay) 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. Roof inspections for ROOFS OVER 6/12 PITCH: 3rd party inspection will be required, the 3rd party inspection report will be collected at final roof inspection performed by City of Wheat Ridge. If report is not available the final inspection will not be completed. The City of Wheat Ridge Third Party Form Check List Property Address Permit Number oto os o Permit Issued Date 2 - Owner Information Property Owner Information 6ily Property Owner Address Inspector Information Inspection Company S LC Inspector Name Inspector Contact info, Inspector Statement and Acknowled e ent 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 has bui ding b en inspected and found to be in compliance with the minimum requirements of I e the 2012 IRC and 2012 IBC as well as all City f444peat Ridge Policies and Procedure and Manufacturer's recommenda d sp ifications. Inspector: Date: 1h -7 Property caner Statement of Ankn^yu1&Aq____4. *1 hearby acknowledge that I am the owner of the building referenced above and I give my consent for the listed third -party inspection company to perform my roof inspection in lieu of the City of WheatRidge inspection. Propery Owner/ Agent: Date: This original document as well as the roofing 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 Kcook@ci.wb acrid 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 ❑ N/A ❑ Pass 0 Fail ❑ N/A 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 Pass [ Fail If new sheathing is installed verify that it is listed in the N�N/A ❑ Pass ❑ permit description (Valuation must be adjusted) [YN/A Fail ❑ Pass ❑ Fail Verify sheathing nail pattern ( See policy & Proceedures) Crickets and saddles where needed ❑ N/A Pass ❑ Fail Verify B vent must have boot same gauge as pipe ❑ N/A Pass ❑ Fail Verify vent caps ❑ N/A ❑ N/APass [] Pass ❑}Fail Verify no flashings are damaged or rusted N/A ❑{Fa;l ❑ Pass El Fail Step flashing shall be min. of 4x4 piece per shingle Verify scuppers allow for proper drainage ❑ N/A Pass ❑ Fail Ice and water shield 2' in heated wall spaces ❑ N/A Pass ❑ ail Underlayments must follow 20 12 IRC / 2012 IBC ❑ NIA � Pass ❑ a;l Verify roof slope for proper drainage ❑ N/A Pass EJ 'Fail Dripedge shall have min of 2" overlap ❑ N/A N/A Pass ❑ ,=ail LSI Pass ❑ !-ail Dripedge should extend down mi " n 2 past roof deck Dripedge shall be mechanically fastened 12" OC N/A ❑ Pass ❑ Fait 90 LB roll roofing shall not be applied pp led 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 Modred Bitumen, EPDM, TPO min slope 1/4:12 slope N/A ❑ Pass ❑ Fail Above roof insulation R-25 N/A ❑ Pass ❑ F3il Below roof residential R-38 [� N/A [ N/A ❑ Pass ❑ Fri) ❑ Pass ❑ F�il Below roof commercial R-32 Modified Bitumen, EPDM, TPO min slope 1/4:12 slope must be installed in accordance with the manufacturers specifications- Must have manufactures letter of warranty with the address on the letter for final inspection ietal Roof Shingles Requirements ❑ N/A ❑ Pass ❑ F,:al Metal roof shingles shall not be installed on slope less 3:12 ❑ N/A ❑ Pass ❑ F„il 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 sections overlapping a a min. of 4" ❑ N/A ❑Pass ❑ Fal Clay and concrete the shall have a min. 2-1/2:12 slope Slopes 4:12 and under require double underlayment The City of Wheat Ridge Inspection Check List notes Mid -Roof Notes Company Name: Inspector signature: Date of Inspection: I The City of Wheat Ridge Inspection Check List notes Final Roof Roof insam.-fion ❑ N/A ❑ Pass ❑ Fail ❑ N/A Pass ❑ Fail Structural roof components ❑ N/A Pass ❑ Fail Verify that no more than 2 layers of shingles ❑ N/A ] Pass ❑ Fail exist Flashing for roof and walls ❑ 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 sheahing nail pattern ( See policy & Proceedures) N/A ❑ Pass ❑ Fail Crickets and saddles where needed ❑ N/A [ Pass ❑ Fail Verify B 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 4x4 piece per shingle j N/A ❑ Pass Fail Verify scuppers allow for proper drainage ❑ N/A [� Pass ❑ Fail Ice and water shield 2' in heated wall spaces EJ N/A ro Pass (] Fail Underlayments must follow 2012 IRC / 2012 IBC ❑ N/A `v Pass [] Fail Verify roof slope for proper drainage ❑ N/A Pass] Fail Dripedge shall have min of 2" overlap ❑ N/A [ Pass Fail Dripedge should extend down min 2" past roof deck ❑ NIA Pass ] Fail Dripedge shall be mechanicaly fastened 12" OC N/A ❑ Pass Fail 90 LB roll roofing shall not be applied to roof slopes f " 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 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 R must be installed in accordance with the manufacturers specifications- Must have manufactures letter of warranty with the address on the letter for final inspection Metal Roof 'hin les Requirements ❑ N/A ❑ Pass ] Fail Metal roof shingles shall not be installed on slope less 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 sections overlapping a a min. of 4" 'file Roofs f1eguirernents ❑ N/A Fl Pass [,] Fail Clay and concrete tile shall have a min. 2-1/2:12 slope Slopes 4:12 and under require double underlayment The City of Wheat Ridge Inspection Check List notes Final Roof Notes Company Name: Inspector signature: Date of Inspection: City of Wheat Ridge Residential Roofing PERMIT - 201705021 PERMIT NO: 201705021 ISSUED: 07/28/2017 JOB ADDRESS: 4540 Teller ST EXPIRES: 07/28/2018 JOB DESCRIPTION: Residential Re -roof to install OC TruDefinition Duration Storm IR4 asphalt shingles with 32sq remove asphalt shingles and install asphalt shingles pitch 5/12 *** CONTACTS *** OWNER (303)421-8454 DAVEY RICHARD A SUB (303)274-1111 Manuel Rocha 021129 Horn Brothers Roofing *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 8,919.00 FEES Total Valuation 0.00 Use Tax 187.30 _ Permit Fee 188.45 ** TOTAL ** 375.75 *** COMMENTS *** *** CONDITIONS *** Effective December 1, 2014, asphalt shingle installations require an approved midroof inspection, conducted when 25-75 percent of the roof covering is installed, prior to final approval. Installation of roof sheathing (new or overlay) 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. Roof inspections for ROOFS OVER 6/12 PITCH: 3rd party inspection will be required, the 3rd party inspection report will be collected at final roof inspection performed by City of Wheat Ridge. If report is not available the final inspection will not be completed. 41 City of Wheat Ridge Residential Roofing PERMIT - 201705021 PERMIT NO: 201705021 ISSUED: 07/28/2017 JOB ADDRESS: 4540 Teller ST EXPIRES: 07/28/2018 JOB DESCRIPTION: Residential Re -roof to install OC TruDefinition Duration Storm IR4 asphalt shingles with 32sq remove asphalt shingles and install asphalt shingles pitch 5/12 I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this permit. I further attest that I am legally authorized to include all entities 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 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 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, an violation of any provision of any a applicabl$, or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. W Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Dan Schultz From: no-reply@ci.wheatridge.co.us Sent: Thursday, July 20, 2017 4:30 PM N To: CommDev Permits Subject: Online Form Submittal: Residential Roofing Permit Application - -- Categories: Gina 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 Property Owner Name Property Owner Phone Number 4540 Teller St Richard Davey 720-934-0029 Property Owner Email Field not completed. Address Do you have a signed Yes contract to reroof this property? It will need to be provided at the time of permit pick-up. CONTRACTOR INFORMATION Contractor Business Name Contractor's License Number (for the City of Wheat Ridge) Contractor Phone Number Horn Brothers Roofin��, 021129 7203912444 Contractor Email Address humberto@hornbrothersroofing.com Retype Contractor Email Address DESCRIPTION OF WORK Are you re -decking the roof? Description of Roofing Material humberto@hornbrothersroofing.com No v OC TruDefinition Duration Storm IR4 Select Type of Material: Asphalt v If "Other" is selected Field not completed. above, describe here: How many squares of the 32 J material selected above? Does any portion of the No property include a flat roof? If yes, how many squares Field not completed on the flat roof? TOTAL SQUARES 32 \1 (pitched + flat) of all roofing material for this proj ect i Provide additional detail Remove asphalt shingles and install asphalt shingles pitch 5:12 here on the description of work. (Is this for a house or garage? What is the roof pitch? Etc) Project Value (contract 8919 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 Humberto Cruz Email not displaying correctly? View it in your browser. 3 HORN BROTHERS ROOFING A COLORADO COMPANY In Business Since 1984 2325 S. JASON STREET DENVER, COLORADO 80223 303-274-1111 ROOFING AGREEMENT OWNER Richard Davev STREET 4540 Teller St. CITY, STATE, ZIP Wheat Ridge CO 80033 PHONE: 720-9 M4029 PHONE: EMAIL: SPECIFICATIONS ® TEAR OFF _ one (1) LAYER (additional layers extra $) ® REPLACE WITH OC TruDefinition Duration STORM IR4 ® COLOR OF SHINGLE brownwood ® MANUFACTURER'S LIMITED WARRANTYLifetime YEAR(S) ® HORN BROTHERS WORKMANSHIP WARRANTY three 3) YEARS) ® VALLEY Closed r90# Fel TS oxed ® RIDGE MATERIAL OC _ V V) T_+ ® DRIP EDGE ® EAVES BROWN ® RAKES BROWN ® HW/SW FLASHINGS In HEADWALL ® SIDEWALL ® REPLACE PIPE JACK BOOTS ®REPLACE LP VENTS ® PAINT ROOF STACKS COLOR match ® I & W ® EAVES ® VALLEY ® PENETRATIONS ® CHIMNEY(S) ® INSTALL SYNTHETIC UNDERLAYMENT SKYLIGHT(S) EXTRA WORK ® CLEAN-UP & HAUL OFF ROOFING TRASH ® CLEAN OUT GUTTERS ® ROLL MAGNET AROUND HOUSE PERIMETER ® REPLACE FURNACE VENT RAIN CAP AND STORM COLLAR SPECIAL INSTRUCTIONS 1. 2. 3. DATE 7114117 EXISTING SPECIAL ATTENTION AREAS ❑ COVER POOL/DECK ❑ PROTECT LANDSCAPE GUTTERS (ANY OLD DAMAGE) M �� C PITCH: ANY AREAS UNDER 4/12 l � 0 YES ❑ NO FIAT AREAS: ❑ YES NO ❑ LEAKS: WHERE AJ 6- EF: ❑ INTERIOR DAMAGE: WHERE 12) DOES DRIVEWAY HAVE CRACKS AYES ❑ NO NOTES EXISTING TYPE ROOF asphalt AGE 5+ PITCH 5:12 ACCESS 5.58 STEEP 0.00 2 -STORY 0.00 Approximate date of installation:we�4�� Deposit amount received - Payment type: (:2,`_ TERMS WE HEREBY PROPOSE to furnish labor and materials in accordance with the specifications, set out herein, for the Sum of $13,652.00 "Contract Price." When fully executed by Company and Owner, this Roofing Agreement becomes a binding contract subject to the scope of work specified herein and the terms on the attached Buyer's Rights and Homeowner Protection Agreement. This Agreement does not include any hidden structural issues uncovered during the tear -off of your roof, such as bad/rotted decking, fascia, trusses, skip sheathing issues or additional layers of shingles. BILLING AGREEMENT 10% deposit' 40%_upon materials arrival, remainder upon comnlPhnn ACCEPTED BY(- DATE 7IM17 ACCEPTED BY DATE 7!14/17 Richard Davey Insurance Carrier: SALESMAN FJi b laesman Policy # elizabeth@,Lwrnbrothersroofinq.com Phone # & Fax #: cell: 303-253-2720, office: 303-274.1111 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: If 0 Job Address: C L/b 1 'e Permit Number: 3 6 I? 8 5 p/ 1i - AA i k ❑ No one available for inspection: Time/f-)AM/PM Re -Inspection required: Ye No When corrections have been made, call for re -inspection at 303-234-5933 Date: �- Inspector: DO NOT REMOVE THIS NOTICE OFFICEFOR USE p City of Da YMx 4�Wh6at s d le !jg N i LO r p Pla/pa iii` �� Building Inspection Services Division 7500 W. 29th Ave., Wheat Ridge, CO 80033 Plan Barre w Fee: Office: 303-235-2855 * `ax: 303-237-8928 Inspection Line: 303-234-5933 Building Permit Application Please complete all highlighted areas on both sides of this . Incomplete applications may not be processed. Pro ss: trOpOrty OwnerA(please pr%t}_Phone: IlLi-ai +0 I Mailing cress:(if different than property address) Address.- City, ddress:Cit , State, Zi cine' l rr E-mail.- Phone: Contractor: Contractors City License #: 0 2� - jj� 12 Phone.. ContractorE-mail ' Address: . Stab Cc Electrical. Plumbing: Mechanical. W.R. City License #I MR. City license # W.R. City License ## Other City Licensed Sub: Other City Licensed Sub: City License # City License Complete all information on BOTH sides of this farm SERVICENEW COMMERCIAL STRUCTURE ELECTRICAL UPGRADE NEW RESIDENTIAL STRUCTURE s COMMEr +., ING COMMERCIAL ADDITION RESIDENTIAL ROOFING w. D i ADDITION WINDOW REPLACEMENT COMMERCIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.) RESIDENTIAL ACCESSORY O.w STRUCTURE r: .:l .. shed, deck, MECHANICAL a• 1►y REPAIR o y•! REPLACEMENT r Y !1 PLUMBING .r• SYSTEM/APPLIANCE i! p4w or w! p CMENT ELECTRICAL y•YM..j REPAIR o Ir ir! REPLACEMENT OTHER (Describe) ,!., `3eerl I ion qOd Sq. Ft.lLF Btu's GaRom Squares Other axe Sq. FULF 0 Gallons Amps Squares Other VV I'ICUL JA� COMMUNin DEVELOPMENT &WW.' Plan # Permit # 41 L t-1 a' 0woor (please 3' �oo, o. Maillog Addrow, (if different then property address) Address: City, State, Zip: 0 SIGNiAl OF UNDERSTANDING AND AGREEMENT I hertby cenify that the setholick distances proluisod by this 1rennit application are accuratic and do not violate applicable ordinanevs, rules or regulations i'& the City (of Wlicat Ridge or covenants, cascluerits or restrictions of record, that all shown and allegations tnadeam accurate, thin I 1mve rvdd and agrec to abide by ull conalitions printed ton this application and that I assume full responsibility for cownpliance with applicuble City of Wheat Ridge codes and ordinati fior rvork undcr any pernilit is'suod based on this applicatkni; that I am the legal ow-ner or have btwn authorized by the letral ow iicr of flic projvrty to perfoon the desscriNA work und am also authorizod by the leg of owner of any entity included on this application to list heart entity on this application, CIRCU08 ' rico' ge of (014'N'ER)<X0 4 SSIGNAl