The URL can be used to link to this page

Home My WebLink About4670 Upham StreetCity of Wheat Ridge Residential Roofing PERMIT - 201702305 PERMIT NO: 201702305 ISSUED: 06/21/2017 JOB ADDRESS: 4670 Upham ST EXPIRES: 06/21/2018 JOB DESCRIPTION: Residential Re -roof to install Tamko Heritage asphalt shingles - 27 sq. *** CONTACTS *** OWNER (303)422-3681 KLASSEN DEANE W SUB (720)242-6404 Rex Corly 150303 Masterpiece Roofing & Painting *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 6,939.00 FEES Total Valuation 0.00 Use Tax 145.72 Permit Fee 156.75 ** TOTAL ** 302.47 *** COMMENTS *** *** CONDITIONS *** Effective December 1, 2014, asphalt shingle installations require an approved midroof inspection, conducted when 25-75 percent of the roof covering is installed, prior to final approval. Installation of roof sheathing (new or overlay) requires an approved inspection prior to installation of ANY roof coverings and is require on the entire roof when spaced or board sheathing with ANY gap exceeding AIA -inch exists. Asphalt shingles are required to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield is required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave and secured in place is required to be provided for all roof inspections. Roof ventilation is required to comply with applicable codes and/or manufacturera€T"s installation instructions, whichever is more stringent. In order to pass a final inspection of elastomeric or similar type roof coverings, a letter of inspection and approval from the manufacturer's technical representative stating that "the application of the roof at (project address) has been applied in accordance with the installation instruction for (roof material brand name) roof covering" is required to be on site at the time of final inspection. City of Wheat Ridge Residential Roofing PERMIT - 201702305 PERMIT NO: 201702305 ISSUED: 06/21/2017 JOB ADDRESS: 4670 Upham ST EXPIRES: 06/21/2018 JOB DESCRIPTION: Residential Re -roof to install Tamko Heritage asphalt shingles - 27 sq. I, by m 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�vorlS,to be performed is disclosed in this document and/ori its' accompanying approved plans and specifications. Signattee of OWNER or CONTRACTOR (Circle one) Date l . 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 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 constr d t a permitfap ev of, an violation of any provision of any applicable code or any ordinance or regulation of this jur' val o n ct to fyeld inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Inspection time requests will be accepted by email only. Please email requests to insptimerequest@ci.wheatridge.co.us between 7:30am and 8:00am, the morning of the inspection. Please put the address of the inspection in the subject line. Antoinette Kulick From: no-reply@ci.wheatridge.co.us Sent: Monday, June 12, 2017 3:40 PM To: Permits CommDev Subject: Online Form Submittal: Residential Roofing Permit Application Residential Roofing Permit Application This application is exclusively for new permits for residential roofs and for licensed contractors only. This type of permit is ONLY being processed online --do not come to City Hall to submit an application in person. Permits are processed and issued in the order they are received. YOU WILL BE CONTACTED WHEN YOUR PERMIT IS READY FOR PICK-UP AND WILL BE GIVEN A SPECIFIC DATE AND TIME WINDOW TO COMPLETE THE TRANSACTION. You will be notified if your contractor's license or insurance has expired, and you may update those documents at the time you are issued your permit. Permits are currently being processed within 3-5 business days, subject to change based on volume. For all other requests: Homeowners wishing to obtain a roofing permit must apply for the permit in person at City Hall. Revisions to existing permits (for example, to add redecking) must be completed in person at City Hall. All other non -roofing permits must be completed in person at City Hall. The Building Division will be open from 7:30-10:30 a.m., Monday through Friday to process these types of requests. THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN REROOFING UNTIL PERMIT HAS BEEN ISSUED. PROPERTY INFORMATION Property Address Property Owner Name Property Owner Phone Number Property Owner Email Address Do you have a signed contract to reroof this property? It will need to be provided at the time of permit pick-up. 4670 Upman st Dean Klassen 3034223681 Field not completed. Yes CONTRACTOR INFORMATION Contractor Name Masterpiece Roofing Contractor's License 150303 Number (for the City of Wheat Ridge) Contractor Phone 7202426404 Number Contractor Email Address scott@masterpieceroofing.com (permit pick-up instructions will be sent to this email) Retype Contractor Email Scott@masterpieceroofing.com Address DESCRIPTION OF WORK Is this application for a Yes new permit for a residential roof? Are you re -decking the No roof? Description of Roofing Tamko Heritage Material Select Type of Material: Asphalt If "Other" is selected Field not completed. above, describe here: How many squares of the 27 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 of all 27 roofing material for this project z Provide additional detail here on the description of work. (Is this for a house or garage? What is the roof pitch? Etc) Project Value (contract value or cost of ALL materials and labor) single family dwelling, house, 4/12 pitch 1 layer 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 scott campbell Email not displaying correctly? View it in your browser. K AngieQsjlist. BBB MASTIERPIECE ACCREDITED BUSINESS ROOFING & PAINTING dx �! 15^iJ' ijr . 4 AS"S8� Email Property Owner ("Owner") Street ("The Property") 4e&70 µ S°s City Wa d — . State 60 Zil Home Phone 1®1 " 't1 •%y' 9 4 -?1 Mr. Cell Mrs. Cell Insurance Company A. Claim # lobi. -C, `lf Qg Adjuster A t1 i=-�i�A- Phone -1461 -3 3 - 7 1.1 "T jX1 3 Shingle Manufacturer Estimated Xactimate Price Year % ColorIOu-� XO�*� Down Payment,-��'`"� �* Tear off�layer(s) of asphalt/shake/tile shingles Balance P �vP _ Install Sheath ing_7/16"OSB_1/2"CDX plywood First insurance check, deductible & upgrades are depriorto scheduling t The estimated dates of service for this job are jlNhere �nstall felt_151b_301b other �`� N "Z1.*��T�G Improvements in exchange for Insurance Scone. V"ce & Water shield to code _ Breakdown and Sunnlemental Proceeds stall Metal Drip Edge. Color Owner authorizes Masterpiece Roofing ("Contractor") to contact the OwnE c/�W,'O t pattern on sh' gle (+20mph wind resist) company regarding damage to the Property. Owner understands that th ey(s)will be _closed _open will assist the Owner in obtaining appropriate property insurance damage _ Ir�siall new pipe jacks gaining approval of damage for repair and obtaining funds to repair Own( fnstall new vents as needed Owner authorizes Owner's insurance company to discuss all matters Install In. ft. of vent -a -ridge t rovide Contractor wi flash chimney brick/wood size�x Re -flash wall abutment as needed if possible (Stucco or siding may be a deterrent) o clean up & haul away all job related debris _ agnetic sweep of the yard for removal of nails 5 year workmanship warranty Contractor, or their representative. Owner agrees o v insurance information, claim number, insurance loss data information a report provided to the Owner by the Insurance Company. Upon authorization of the Owner's Insurance Company, for a price agrc Contractor, Owner agrees that the Contractor shall perform work press Insurance Company's loss data sheet or adjuster's report which includes of repair as set forth in the insurer's claim file plus any upgrades selected t Special instructions K E fA,�*- 5—e,0 $ K R-6 L - Of CO gk , 0 Ca µa Ci A Owner is obligated to pay only the deductible required by the Owner's Insurance Company plus any upgrades requested by the Owner. Owner further agrees to endorse insurance checks payable to the Contractor or to pay the Contractor an equal amount. Owner owes the Contractor nothing in the event the Insurance Company does not authorize the repairs. > Contractor shall hold in trust any payment received from you until Contractor has delivered roofing materials at the site or has performed a majc roofing work on your property. Owner has the right to rescind this contract and obtain full refund of any deposit within 72 hours after entering the contract. Contractor cannot pay, w all or part of any insurance deductible applicable to the insurance claim for payment for roofing work on your property. Otherwise, Owner understands that this is a binding agreement. If the Owner breaches this agreement before commencement of the work, Owner the Contractor for the actual work performed. Owner understands that, aside from upgrades, a summary of the work to be performed, a description of materials to be used or a list of standard feat the total contract price, or description of the basis on which the price will be calculated, is embodied in the insurance loss data information provided t insurer. Further, Owner authorizes the Contractor to submit supplemental requests to the Insurance Company for additional payment required for from adjuster scope or due to price fluctuation caused by supply/demand issues orotherwise unknown at the time the contract was entered. Owner warrants that this contract is signed without any reliance upon any representations or promises by the Contractor, or its agents, except I specifically written in this contract, and that no additional promises or representations have been offered as inducement for signing. Owner also reading all the Terms and C nditions on the reverse side of this document. Date �3 f Representative Zxo- 40 �a 770o E. Iliff Ave., Suite D, Denver, CO 80231 Property Owner Property Owner 72o-242-6404 � Y 'cZ t4t-e job. insurance', ontractor' ustments, Property. �ctly with my and all adjuster's ble to the ed by the estimate ne Owner. of the or rebate yes to pay included, e Owner's aed items e that are 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: L1& 70 %yPoe Iq f Permit Number: 2 017 23 0 1 ❑ No one available for in, ion: Time -F- 0 AM/PM Re -Inspection required: es o When correct'ons have been made, call for re -inspection at 303-234-5933 Date: Inspector: Ml,� DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE _��9�Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Job Address: Permit Number: o�S ❑ No one available for inspection: Time Re -Inspection required: Yes When corrections have been made, ca ft r ie -inspection at 303-234-5933 P j Date: &/,:,;,% Inspector: \V,)* DO NOT REMOVE THIS NOTICE S+ � � 1 q � I Uccu ancvjfive INSPECTION RECORD J INSPECTION REQUEST LINE: (303) 234.5933 Inspections will not be performed unless this card is posted on the project site. Call the inspection request line before 11:59 p.m. to receive an inspection the following business day.** Inspector Must Sign ALL Spaces pertinent to this project Foundation Inspections Date Inspector Initials Pier Concrete Encased Ground (CEG) Foundation / P.E. Letter Do Not Pour Concrete Prior To Underground/Slab Inspections Date Inspector Initials Electrical Sewer Service Comments I Of The Above Inspections Plumbing Do Not Cover Underaround or Below/In-Slab Work Prior To A Rough Inspections Date Inspector Initials Wall Sheathing Mid -Roof Lath / Wall Tie Rough Electric' Rough Plumbing/Gas Line Rough Mechanical Rough Framing Insulation Drywall Screw / Nail Final Inspections Date Inspector Initials Final Electrical 27 -/6 13 �J Final Plumbing Final Mechanical Roof Final Window / Doors Final Building Landscaping 8 Parking / Planning Dept. ROW 8 Drainage / Public Works Dept. Fire Inspection / Fire Protection Dist. Comments Cit of tiheat Ride @9/2/2616 16:5 CDBA Upgrading existing o CDA013349 EPSP 4670 Upham ST APDL/PERMIT NO: 261601481 PAYMENT RECEIVED MC / 1684 AUTH CODE: 026644 TOTAL ----------------- AMOUNT 147.35 AMOUNT 147.35 147.35 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. NOTE: All items must be completed and approved by Planning, Public Works, Fire and Building before a Certificate I 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 ,y the Building Division. "For Inspection Time Window Requests — Please email ins ptimereguest asci wheatri!!�ge.co.us by 8:00 A.M. the day of the nspection with the property address in the subject line of the email. Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued Protect This Card From The Weather i CITY OF WHEAT RIDGE ��9rV, Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: r Job Address: �{'�� `� 5 Permit Number: ❑ No one available for inspection: Time 7 • Z AM/PM Re -Inspection required: Yes No * When corrections have been made, call for re -inspection at 303-234-5933 Date: Inspector: IV' - DO NOT REMOVE THIS NOTICE *** 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.Must comply w/ 2012 IRC & 2014 NEC. Subject to field inspection. I, by m 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. Thispermit 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 anmanner shall be performed that shall results in a change of the natural flow of water without prior and specific approval. 5. The permit holdy er 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 code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. 1 ) /i t 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 Ridge Residential Electric PERMIT - 201601481 PERMIT NO: 201601481 ISSUED: 09/26/2016 JOB ADDRESS: 4670 Upham ST EXPIRES: 09/26/2017 JOB DESCRIPTION: Upgrading existing overhead service to 200 amps *** CONTACTS *** OWNER (303)422-3681 KLASSEN DEANE W GC (303)422-9219 J. David Doherty 018046 Piper Electric Co. *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: / SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 3,000.00 FEES Total Valuation 0.00 I D Use Tax Permit Fee 54.00 93.35 v ** TOTAL ** 147.35 *** 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.Must comply w/ 2012 IRC & 2014 NEC. Subject to field inspection. I, by m 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. Thispermit 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 anmanner shall be performed that shall results in a change of the natural flow of water without prior and specific approval. 5. The permit holdy er 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 code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. 1 ) /i t Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Occupancy/Type INSPECTION RECORD �J INSPECTION REQUEST LINE: (303) 234-5933 Inspections will not be performed unless this card is posted on the project site. Call the inspection request line before 11:59 p.m. to receive an inspection the following business day.** Inspector Must Sign ALL Spaces pertinent to this project Foundation Inspections Date Inspector Comments Initials Pier Concrete Encased Ground (CEG) Foundation / P.E. Letter I I Do Not Pour Concrete Prior To Approval Of The Above Inspections Underground/Slab Inspections Date Inspector Comments Initials Electrical Sewer Service Plumbing Do Not Cover Underground or Below/In-Slab Work Prior To A Rough Inspections Date Inspector Initials Wall Sheathing Mid -Roof Lath / Wall Tie Rough Electric Rough Plumbing/Gas Line Rough Mechanical Rough Framing Insulation Drywall Screw / Nail Final Inspections Final Electrical Final Plumbing Final Mechanical Roof Final Window/ Doors Final Building Landscaping & Parking / Planning Dept. ROW & Drainage / Public Works Dept. Fire Inspection / Fire Protection Dist. CityY of Wheat Ride 09/2b/2016 18:.,5 CDBA Upgrading existing o CDA013349 AMOUNT BPSP 4670 Upham ST 147.35 APDL/PERMIT NO: 201601481 PAYMENT RECEIVED AMOUNT MC / 1684 147.35 AUTH CODE: 026644 Date Inspector TOTAL __ __ ______147_35 Initials _ _ _ _ __ 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. 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. **For Inspection Time Window Requests — Please email insptimerepuest(o)ci wheatrid4e.co.us by 8:00 A.M. the day of the inspection with the property address in the subject line of the email. Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued Protect This Card From The Weather FOR OFFICE USE ONLY . A Date: - City of �' W heat jd c COMMUNITY DEVELOPMENT Plan/Permit # Building & Inspection Services Division ),o ( Y a I q �1 7500 W. 291" Ave., Wheat Ridge, CO 80033 Plan Review Fee: Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: permits .ci.wheatrid4e.co.us Building Permit Application *** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: 4670 Upham St. Property Owner (please print): Dean Klassen Phone: 303-422-3681 Property Owner Email: deanwheatridge@aol.com Mailing Address: (if different than property address) Address: , State, Zi Arch itect/Engineer: Architect/Engineer E-mail: Phone: Contractor: Piper Electric Co., Inc./Werner Schlichter Contractors City License #: 18046 Phone: 303-422-9219 Contractor E-mail Address: wschlichter@piperelectric.com Sub Contractors: Electrical: 19 6 4 W.R. City License # 18046 Other City Licensed Sub: City License # Plumbing: W.R. City License # Other City Licensed Sub: City License # Mechanical: W.R. City License # Complete all information on BOTH sides of this form ❑ COMMERCIAL [RESIDENTIAL Description of work: (Check all that apply) ❑ NEW COMMERCIAL STRUCTURE [} ELECTRICAL SERVICE UPGRADE ❑ NEW RESIDENTIAL STRUCTURE ❑ COMMERCIAL ROOFING ❑ COMMERCIAL ADDITION ❑ RESIDENTIAL ROOFING ❑ RESDENTIAL ADDITION ❑ WINDOW REPLACEMENT ❑ COMMERCIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.) ❑ RESIDENTIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.) ❑ MECHANICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT a PLUMBING SYSTEM/APPLIANCE REPAIR or REPLACMENT [� ELECTRICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT ❑ OTHER (Describe) (For ALL projects, please 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.) Upgrading existing overhead service to 200 amps. Sq. FULF Btu's Gallons Amps C, t_) Squares Other Project Value: (Contract value or the cost of all materials and labor included in the entire project) 3000.00 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: (OWNER) (CONTRACTOR) I r (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) I'.Iectrnnic Sip -nature (first and last na,,): Werner Schlichter Contractor DATE: 9/26/2016 ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS. Reviewer: DEPARTMENT USE ONLY OCCUPANCY CLASSIFICATION: Building Division Valuation: $