HomeMy WebLinkAbout3019 Eaton Streeti CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type: P U hl
Job Address: > y 1 C` v�,-_.rn 5
Permit Number: � v Z V C 0 � _1
❑ No one available for inspection: Time - AM/PM
Re -Inspection required: Yes 'No
When corrections have been made, schedule for re -inspection online at:
http✓/www.ci. wheatridge.co. uslinspection
Date: Ll -3 Inspector: �-j
DO NOT REMOVE THIS NOTICE
City of Wheat Ridge
Residential Plumbing PERMIT - 202000635
PERMIT NO: 202000635 ISSUED: 04/01/2020
JOB ADDRESS: 3019 Eaton St EXPIRES: 04/01/2021
JOB DESCRIPTION: Interior underground plumbing repair in bathroom - 14 ft long
*** CONTACTS ***
OWNER (720)891-5362 STARKER WILLIAM J
SUB (303)287-9009 BRAD WAKEHAM 130022 TRENCH RIGHT LLC
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2412 / LAKESIDE, STEWART GARDENS, OLI BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 7,500.00
FEES
Total Valuation 0.00
Use Tax 157.50
Permit Fee 172.60
** TOTAL ** 330.10
*** COMMENTS ***
*** CONDITIONS ***
All work shall comply 2012 International Codes, 2017 NEC (if applicable), and ordinances
adopted by the City of Wheat Ridge. Work is subject to field inspections.
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 alI 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 maybe subject to a fee equal to one-half of the originalpermitfee.
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, 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 Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
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Kimberly Cook
From: no-reply@ci.wheatridge.co.us
Sent: Wednesday, April 1, 2020 9:48 AM
To: CommDev Permits
Subject: Online Form Submittal: Permit Application (For permits which do not have a form
already)
Categories: Kim
Permit Application (For permits which do not have a form already)
This application is exclusively for Scopes of Work that do not already have a
specific form
YOU MUST ATTACH AN ELECTRONIC PAYMENT 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.
PROPERTY INFORMATION
Property Address
Property Owner Name
Property Owner Phone
Number (enter WITH
dashes, eg 303-123-4567)
Property Owner Email
Address
Attach Credit Card
Authorization Form -
**DO NOT ATTACH
RANDOM
DOCUMENTS
3019 EATON ST
MARY STARKER
303-475-2990
Field not completed.
WHEAT RIDGE CARD AUTHORIZATION FORM 4-
104012020. pdf
CONTRACTOR INFORMATION
Contractor Business TRENCH RIGHT
Name
Contractor's License 000508
Number (This is a 5 or 6
digit number for the City
of Wheat Ridge)
Contractor Phone 3032879009
Number (enter WITH
dashes, eg 303-123-4567)
Contractor Email Address OFFICE@TRENCHRIGHT.COM
Retype Contractor Email OFFICE@TRENCHRIGHT.COM
Address
DESCRIPTION OF WORK
Detailed Scope of Work - 14' INTERIOR UNDERGROUND PLUMBING REPAIR
Provide a detailed
description of work
including mechanical,
electrical, plumbing work
occurring,
adding/removing walls,
etc.
Location of work INTERIOR BATHROOM
(backyard, on roof, etc)
Project Value (contract 7500
value or cost of ALL
materials and labor)
Upload drawings, if Field not completed.
needed
SIGNATURE OF UNDERSTANDING AND AGREEMENT
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.
I understand that work
may not begin on this
property until a permit
has been issued and
posted on the property.
Yes
Yes
2
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.
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 JASON LAMB
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:
Job Address: ' ii =
Permit Number:
3
a
❑ No one available for inspection: Time AM/PM
Re -Inspection required: Yes No t
L..
When corrections have been made, schedule for re -inspection online at:
http://www, ci, wheatridge. co. usVinspection
Date: r- i u�nspector: 'g
DO NOT REMOVE THIS NOTICE
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:ADDRESS_ JOB CODE:
i ,r
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
308 Rough Electrical Residential
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��
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:(/ E�-x-,,�-Q�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
Final Inspections
Date
Inspector
Initials
Comments
401 Gasline
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
y; j ;
1T1:-:bvn am lHE)
r mJ
410 Final Window/Door
V
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
Owner Information
Property Owner Information
Property Owner Address
The City of Wheat Ridge
Third Party Form Check List
-15-1
Inspector Information
Inspection Company
Inspector Name
Inspector Contact info.
30 1`1 E --o 'S
Me4,_o,`1— Late_, L..L.(L,
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
recommend a ' s specifications.
Inspector: Date: _
Property Owner Statement of Acknowledgement
*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 he�Ri �geui ding Division inspection.
Propery Owner/Agent: _ Date:
This original document and permit card, as well as the roofing check list, must be submitted tc
the Chief Building Official within seven days of the final inspection.
Drop off in person
Permit counter 2nd floor
7500 W. 29th Ave
Wheat Ridge CO 80033
Draft Date: 7/26/17
Please add note to reverse side
❑ N/A
❑ N/A
❑ N/A
❑ N/A
N/A
Q N/A
❑ N/A
❑ N/A
❑ N/A
❑ N/A
❑ N/A
❑ N!A
❑ N/A
❑ N/A
❑ N/A
❑ N/A
❑ N/A
❑ N/A
❑ N/A
❑ N/A
❑ N/A
❑ N/A
Q N/A
Q NIA
❑ N/A
❑ N/A
Q N/A
The City of Wheat Ridge
Inspection Check List notes
Mid -Roof
_Roof Inspection�'�
❑ Pass ❑Fair i 4 �,v " �i
❑ Pass ❑ail Structural roof components
❑ ZD
Fail Verify that no more than 2 layers of shingles exist
❑ PFail Flashing for roof and walls
❑ PFail If new sheathing is installed verify that it is listed in the
Permit description (Valuation must be adjusted)
Q P El Verify sheathing nail pattern (See Policy & Pr000dures)
❑ PFail Crickets and saddles where needed
❑ ass ❑ Fail Verify B vent must have boot same gauge as pipe
Pass E] Fail Verify vent caps
Pass ❑ Fail Verify no flashings are damaged or rusted
Pass ❑ Fail Step flashing shall be min. of 4x4 piece per shingle
❑ Pass ❑ Fail Verify scuppers allow for proper drainage
❑ Pass E] Fail Ice and water shield 2' in heated wall spaces
❑Pass ElFail Underlayments must follow 2012 IRC / 2012 IBC
❑ Pass ❑ Fail Verify roof slope for proper drainage
❑ Pass ❑ Fail Dripedge shall have min of 2" overlap
❑ Pass ❑ Fail Dripedge should extend down min 2
El Pass ❑ Fail Dripedge shall be mechanicaly fastened 12" OC
eck
❑ 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
❑ Pass ❑ Fail Modified Bitumen, EPDM, TPO min slope 1/4:12 slope
❑ Pass ❑ Fail Above roof insulation R-25
❑ Pass ❑ Fail Below roof residential R-38
❑ Pass ❑ Fait Below roof commercial R-32
❑ Pass ❑ Fail 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
Metal Roof Shincales Requirements
❑ Pass ❑ Fail Metal roof shingles shall not be installed on slope IeS�
3:12
❑ Pass ❑ Fail Metal valley flashing shall be the same material as roof
❑ 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 Requirements
Q Pass ❑ Fail Clay and concrete the shall have a min. 2-1/2.12 slope
slopes 4:12 and under require double undedayment
The City of Wheat Ridge
Inspection Check List notes
Mid -Roof
Notes
Company Name:
Inspector signature:
Date of inspection:
The City of Wheat Ridge
Inspection Check List notes
Final Roof
Roof Inspection
❑ N/A
❑ Pass
❑ Fail
❑ N/A
,,Pass
❑ Fail
Structural roof components
❑ N/A
FfPass
❑ Fail
Verify that no more than 2 layers of shingles exist
N/A
Pass
❑ Fail
Flashing for roof and walls
❑ Pass
❑ Fail
If new sheathingis installed ailed venfy that it Is listed In the
permit description (Valuation must be adjusted)
/A
❑ Pass
❑ Fail
Verify sheathing nail pattern (See Policy & Procedures)
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
Erpass
❑ Fail
Verify vent caps
❑ N/A
.ET Pass
❑ Fail
Verify no flashings are damaged or rusted
❑ N/A
Zpass
❑ Fail
Step flashing shall be min. of 4x4 piece per shingle
Q N/A
❑ Pass
❑ Fail
Verify scuppers allow for proper drainage
❑ N/A
J?1 Pass
❑ Fail
Ice and water shield Z in heated wall spaces
❑ N/A
Pass
❑ Fail
Underlayments must follow 2012 IRC / 2012 IBC
❑ N/A
it Pass
❑ Fail
Verify roof slope for proper drainage
❑ N/A
a Pass
❑ Fail
Dripedge shall have min of 2" overlap
❑ N/A
"Pass
❑ Fail
Dripedge should extend down min 2" past roof deck
❑ /A
[2 Pass
❑ Fail
Dripedge shall be mechanicaly fastened 12" OC
N/A
❑ Pass
❑ Fail
90 LB roll roofing shall not be applied to roof
PP 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
❑ 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
3:12
N/A
❑AN/A
❑ Pass
❑Pass
❑ Fail
❑
Metal valley flashing shall be the same material as roof
Fail
Metal valley flashing shall extend a min of 8" from the
j
centerline with a min. of 3/4 " high splash diverter
f
rib built-in at the flow line with sections overlapping a
a min. of 4"
I
Tile Roofs Requirements
N/A
❑ 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
c? u '— 2 ---��
v
Company Name: L,, dtgoi
Inspector signature:
Date of Inspection: c
A City of Wheat Ridge
Residential Roofing PERMIT - 201801403
PERMIT NO: 201801403 ISSUED: 05/15/2018
JOB ADDRESS: 3019 Eaton ST EXPIRES: 05/15/2019
JOB DESCRIPTION: Residential re -roof with Owens Corning Duration Storm asphalt shingles on
house and sheds. Pitch: 9/12 Squares: 47
*** CONTACTS ***
OWNER (720)891-5362 STARKER WILLIAM J
SUB (720)891-5362 Dmitriy Tsybulskiy 160141 Colorado Roofers, LLC
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2412 / LAKESIDE, STEWART GARDENS, OLI BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 14,139.34
FEES
Total Valuation 0.00
Use Tax 296.93
Permit Fee 283.55
** TOTAL ** 580.48
*** COMMENTS ***
*** CONDITIONS ***
Midroof & Final Roof inspections for ROOFS 6/12 PITCH & OVER: 3rd party inspection will be
required for both the midroof and final inspections. 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.
REGARDING ROOF VENTILATION: Roof ventilation shall comply with IBC Sec. 1203.2 or IRC Sec.
8806. The installation of ridge venting requires the installation or existence of soffit
venting. For calculation purposes, one hat or turtle vent equal to one-half of one square
foot of opening.
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.
ro City of Wheat Ridge
Residential Roofing PERMIT - 201801403
PERMIT NO: 201801403 ISSUED:
JOB ADDRESS: 3019 Eaton ST EXPIRES:
JOB DESCRIPTION: Residential re -roof with Owens Corning Duration
house and sheds. Pitch: 9/12 Squares: 47
05/15/2018
05/15/2019
Storm asphalt shingles on
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 perrmt. I further attest that I am le ally authorized to include all entities named within this document as parties to the work to be
perforined%and that all wor pe ormed i disclosed in this document and/or itis' accompanying approved plans and specifications.
5 /116
Signature of OWNS or NTRACTOR'(Circle one) Date
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 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 an manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval.
51 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 code or any,ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection.
Signature of Chef Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
City of
�W heat'ogle
MUNITY DEVELOPMENT
Building & Inspection Services Division
7500 W. 291h Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933
Email: permits(cDci.wheatridge.co.us
I FOR OFFICE USE ONLY I
Date: .3— / /
Add to Permit #j /Q 1( 103
Building Permit Revision/Amendment Application
*** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. ***
Property Address: �2LZZ c�;-' kryl S�-
Property Owner (please print): &,d Phone:
Property Owner Email:_ rS N ba k9-4 e 9ma i I L cyt7
Mailing Address: (if different than property address)
Address:
City, State, Zip:
Submitting Company: (" C�, (c, I'L ;e-+ s
Contact Person: D,1M.AL��rb.l s � Phone: �-Xy -� r S 3G2
Contractor: 6010 -rA--&"'; %t S
Contractors City License #: 16 Phone: � -� — w — S -
Contractor E-mail Address: i P) A) f�) ry( -le dlk�-
Please Note: Additional valuation must include all general and subcontracted work to be performed
related to the revisions and/or amendments declared in the description of work and which were not
included in the original permit valuation.
If revisions or amendments increase the original valuation, additional fees will be due at the time of
approval. Depending on the scope of work, additional plan review fees may be due upon approval
($60.00 an hour — 2 hour minimum).
Description of revised/amended work:
/Zvi F - by �ve—
Sq. Ft./LF
Amps
I (QV\ (46 � 3-Q
Btu's
Squares
Gallons
Other
Additional Project Value: (Must include all general and subcontracted work to be performed related to revisions/amendments described above)
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.
CIRCLE ONE: (OWNER) (CONTRACTOR) or (AUTAORI REPRESENTATIVE) of (OWNER) (CONTRACTOR)
PRINT NAME: SIGNATURE: S / 7 (� )DATE:
DEPARTMENT USE ONLY
ZONING COMMMENTS:
Reviewer:
BUILDING DEPARTMENT COMMENTS:
Reviewer:
PUBLIC WORKS COMMENTS:
Reviewer:
PROOF OF SUBMISSION FORMS
Fire Department ❑ Received ❑ Not Required
Water District ❑ Received
Sanitation District ❑ Received
OCCUPANCY CLASSIFICATION:
❑ Not Required
❑ Not Required Building Division Valuation: $
Dina Kern
From:
Sent:
To:
Subject:
DI k 6l L/03 -S-7
no-reply@ci.wheat ridge.co.us
Tuesday, May 15, 2018 8:34 AM
CommDev Permits
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 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 rel
REROOFING UNTIL PERMIT HAS BEEN ISSUED. �• I
Is this application for a Yes
residential roof?
How many dwelling units Single Family Home
are on the property?
PROPERTY INFORMATION
Property Address 3019 Eaton St�i"
Property Owner Name Bud Starker
Property Owner Phone 720-891-5362
Number (enter WITH
dashes, eg 303-123-4567)
Property Owner Email tsybulskiy@gmail.com
Address 1590,
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
Yes
Colorado Roofers contract (signed) 10 May 2018.pdf
CONTRACTOR INFORMATION
Contractor Business
Name
Contractor's License
Number (This is a 5 or 6
digit number for the City
of Wheat Ridge)
Contractor Phone
Number (enter WITH
dashes, eg 303-123-4567)
Contractor Address
(Primary address of your
business)
Colorado Roofers
160141
720-891-5362
2600 S Parker Rd. Bld 3, Suite 237 Aurora CO 80014
Contractor Email Address tsybulskiy@gmail.com
Retype Contractor Email tsybulskiy@gmail.com
Address
DESCRIPTION OF WORK
1
TOTAL SQUARES of C50
the entire scope of work:
p �
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
both? (check all that
apply)
Pitched roof (2:12 pitch or greater)
2
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)
9:12
47
Owens Corning Duration Storm
Asphalt
House and Sheds
SIGNATURE OF UNDERSTANDING AND AGREEMENT
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.
I understand that this
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
may not begin on this
property until a permit
has been issued and
posted on the property.
I certify that I have been
authorized by the legal
owner of the property to
submit this application
Yes
Yes
Yes
Yes
3
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 Dmitriy Tsybulskiy
Email not displaying correctly? View it in your browser.
T City of Wheat Ridge
E -Res. Siding Replacement PERMIT - 201801423
PERMIT NO: 201801423 ISSUED: 05/16/2018
JOB ADDRESS: 4310 Garland ST EXPIRES: 05/16/2019
JOB DESCRIPTION: Remove and replace 28 squares of Satinwood steel siding.
*** CONTACTS ***
OWNER (303)919-0107 STIEVE ELENA
SUB (720)707-6963 Michael Lindquist 160047 5280 Exteriors
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2002 / KIPLING, I-70 & CLEARCREEK ARE BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 19,874.40
FEES
Total Valuation 0.00
Use Tax 417.36
Permit Fee 362.80
** TOTAL ** 780,16
*** 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 2012 IRC & 2014 NEC. Per IRC Sec. R314, smoke detectors are required
to be installed in every sleeping room, in hallways outside of sleeping rooms, and on every
level of the structure.
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
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 originalpermit tee.
1 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 code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection.
Signature of Chief ]AiiilLOfficial Date
REQUESTS MUST BE HAVE BY 11:59PH ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
City of
Wheatj�idge
COMMUNITY DEVELOPMENT
Buildings $ Inspection Services Division
7500 W. 29"' Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933
Email: permits(a d.wheatridge.co.us
FOR OFFICE USE ONLY
Date:
Plan/Permit # 2P 1W1qZ3
Plan Review Fee: 17VO . % /
Building Permit Application
Please complete all highlighted areas on both sides of this form. Incomplete applications
may not be processed. I
Property Address: `f3/0
Property Owner (please print): �1�10! o�7(?'we. Phone: 303 C,/ ! 9' v!U -7
Property Owner Email: ."4
Tenant (Commercial Projects Only)
Property Owner Mailing Address: (if different than property address)
Address: 9"4-f_
City, State, Zip:
Architect/Engineer E-mail:
Phone:
Contractor: en tib 6,Q^avitt4 ZBA-- -5:9�&U 6�(_ ku4ya
City of Wheat Ridge License #: / W01-7 Phone: 70 -LO -70 7 9a 3
Contractor E-mail Address: !?AP --
-W
For Plan Review Questions & Comments (please print):
CONTACT NAME (please print): m i!k LI ` Lp(oto, 6 Phone: 7610 ?O 7 9'( 3
CONTACT EMAIL(please print):_ q}S ICG
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.
A10
Commercial Projects Only: Occupancy Type:
Sq. FULF
Amps
BTUs
Squares
Construction Type:
Gallons
Project Value: (Contract value or the cost of all materials and labor included in the entire project)
/1. 8-7VqV
OWNERICONTRACTOR 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 1 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. 1, the applicant for this building permit application, warrant the
truthfulness of the information provided on the application.
CIRCLE ONE: (OWNER) (CONTT R%A�CT`d or (�UTHPRIZE)I% REPRESENTATIVE) of (OWNER) (CONTRACTOR)
i na re (first and last name): i , L!, / . �/ ` DATE:
Mccic. �.tn4
Printed Name: %-y4 S
ZONING COMMMENTS:
Reviewer;
BUILDING DEPARTMENT COMMENTS:
Reviewer:
PUBLIC WORKS COMMENTS:
Reviewer:
OCCUPANCY CLASSIFICATION:
CONSTRUCTION TYPE:
Building Division Valuation:
i. CITY OF WHEAT RIDGE
Bu Iaing`fnspecti'on [Dials 6n
(303) 234-5933 Inspection line_1�9r;•T
(303) 235-2855 Office • (303) 237-8929 Fax
t
INSPECTION NOTICE
Inspection Type: 30(_Al1�tle_'
Job Address: S1,
Permit Number: 70/601 CD3
5r 0
❑ No one available for inspection: Time z , `� AMtm)
Re-Inspection required: Yes (No
When corrections have been made, call for re -inspection at 303-234-5933
Date: S/ 1/ l 0 Inspector:
DO NOT REMOVE THIS NOTICE
INSPECTION RECORD
��SP�ECTIO�NRE�QUES�T LINE: (303) 234-5933
lnq=dons will not be performed unless this card is posted on the PrOject site.
Call inspection requestling before 11:59 p.m. to receive following business day.
Inspector Must Sign ALL Spaces pertinent to We projeet
Foundation Int Comments
t t spector
Moriolithk Stab Raintimemero
calssom
Rough Mechani64
Dry"11 Screw/ Nail
r
Landscaping & Parking Planning Dep
ROW Drainage Pubk Wotks Dept,
,�
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BUILDING DEPARTMENT
237.6944 Ext. 255
CITY OF WHEAT RIDGE
* *
Correction Notice
I
,
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Job Located at ...., ,.'.'..:.I...........~ . .............................................
I have this day inspected this structure and these premises and
have found the following violations of City and/or State laws
governing same:
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( -'':; ;/'P//' /;"-~l#~~}'---~/I(-
You are hereby notified to correct the foregoing violations.
When corrections have been made, call for inspection.
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Inspector for Building Dept.
FORM WR6-ZZ
DO NOT REMOVE THIS TAG
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DATE:
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DATE INSP. REO. /u - ? (if IJ7
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DATE:
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DEPARTMENT OF COMMUNITY DEVELOPMENT
BUILDING INSPECTION DIVISION
CITY OF WHEAT RIDGE, COLO.
THIS PERMIT. VALID ONLY WHEN S'GNED BY THE CH'EF BUILDING INSPECTOR AND THE MAYOR - CALL 24 HDURS PRIOR TO INSPECTION
TWO SETS OF BUILDING PLANS AND TWO PLOT PLANS MUST ACCOMPANY THIS APPLICATION
;:;INESS NAME ADDRESS .301Q E:'ArON -5r.
COpy OF DEED AND 'MPROVEMENT SURVEY REQU'RED
--
REAR PROPERTY LI NE
PERT.Y L1N~_
STREET NAME - ~~ I (CIRCLE FRONT) N E S '1/
SHOW DISTANCES FROM THE MAIN BUILDING TO ADJOINING HOUSES, STREETS, AND PROPERTY LINES ON ABOVE SKETCH;
SHOW LEAST DISTANCE TO PROPERTY LINES, NOT MAXIMUM OR AVERAGE DISTANCE.
OWNERS NAME~ I U.I AV\ ,/ I 5 TA RILE [2..
CONTRAC~ L1C. NO. ~ METES AND BOUNDS DESCRIPTION ATTACHED
ADDRESS. I EATot-l "5r: PHONE"2-~3-V~-l- ADDRESS ~lqt.e~/ON. ".5/.
CITYj;)_f2.../--CD ZIPCODE~ LOTNO~ BLOCK NO. ("
LOT WIDTH I CO' DEPTH I ~:3 I AREA 3 SUBDlVISION~..J fJ6)lf I!.- C~ ~I ~
INDICATE THOSE OF THE FOLLOWING OFF -SITE IMPROVEMENTS NOW EXISTING' Curb 8 Gult... ~~r t PavlnQ V'I/oter V- sewer VSfcrm llruinoge_
I HAVE ARRANGEMENTS BEEN MADE TO PROVIDE FOR THOSE NOT NO'II EXISTING YES_NO_ N. 'Po
f- ARE THERE ANY SPECIAL ASSESSMENTS AGAINST THIS PROPERTY' YES_NO~
\ OCCUPANCY EXTERIOR MATERIALS WALLS~ ROOF 614 I 0\1 ~6
~STORIES UN'TS REMARKS,!+tOI"f11l1-l ""[0 ':>INI:>~F~M-IL'f ~OM.F_
'\ OWNER / CONTRACTOR S'GNATURE OF UNDERSTANDING AND AGREEMENT PERMIT FEE
I hereby certify that the above setback distances, shown on this permit application ore accurate. and do not violate USE TAX
applicable ordinances, rules or regulations of the City of Wheat Rdge or covenonta, easements or restrictions of re-
1 cord; that all measurements shown, and olleoations mode ore accurate; thot I have read and agree to abide by 011 TOTAL FEE $ 0' 1. J
I cO~ditions printed on this application, and that I assume tull responsibility tor compliance with the Wheat Ridge NOT VALID UNLESS RECEIPTED
~,}lUlldlno Code (U.S.C.) and all other a'11i;abll.",eot Ri~-OrdjnOnCesl for work under this permit. If
(OWNERHCONTRACTOR) SIGNED tv V . DATE,!) '2.1
--,-
BUILDING DEPARTMENT USE ONLY
COST \ ~
THE PROPERTY LOCATED AT~GA\T 1)~0\
'S PRESENTLY ZONED 17 .:=, 1:--.7\"\;z..,.U ~\
e THE PROPOSED USE (_IS) <-'S NOT) AL'LoW'ED UNDElrTHE ZONING ORDINANCE
BY
DATE
':ONOITIONS'
(Il "rHIS PERMIT WAS ISSUED IN ACCORDANCE WITH THE PROVISIONS SET FORTH IN YOUR APPLICATION AND IS SUBJECT TO THE LAWS OF THE STATE OF COLORADO
AND TO THE ZONING REGULATIONS AND BUILDING CODE OF WHEAT RlOOf, COLORADO OR ANY OTHER APPLICABLE ORDINANCES OF THE CITY.
(2) "HIS PERMIT SHALL EXPIRE IF (Al THE WORK AUTHORIZED IS NOT COMMENCEO WITHIN SIXTY (60) DAYS FROM ISSUE DATE OR (8) THE BUILDING AUTHORIZED IS
~,USPENDfD OR ABANDONED fOR A PERIOD Of 120 DAYS
(3) IF THIS PERMIT EXPIRES, A NEW PERMIT MAY BE ACQUIRED FOR A FEE OF ONE-HALF THE AMOUNT NORMALLY REQUIRED, PROVIDED NO CHANGES HAVE BEEN OR WILL
elE MADE IN THE ORIGINAL PLANS AND SPECIFICATIONS AND ANY SUSPENSION OR A8ANOONNENT HAS NOT EXCEEDED ONE (I) YEAR. IF CHANGES ARE MADE OR IF
~;USPENSION OR ABANDONMENT EXCEEDS ONE (I} YEAR, FULL FEES SHALL BE PAID F A NEW PERMIT.
(4) ~IO WORK OF ANY MANNER SHALL BE DONE THAT WILL OBSTRUCT THE NATURAL F F WATER CAUSING 0 ~IN PROBLEM.
(5) CONTRACTOR SHALL NOTIFY THE BUILDING INSPECTOR TWENTY-FOUR (24) HOU I A .....CE FOR ALL NS C 0 S AND SHALL RECEIVE WR!TTEN APPROVAL
ClN INSP ION C 0 8EFc.2:;;;~'::~-"CCESS'VE PHASES OF THE
n;oo WESt 2~lh AVENUE
2:'7-&944 EXT. 255 P.O. BOX 638
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COMMENTS'
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BUILDING COST $
PLUMBING PERMIT
ELECTRICAL PERMIT
STATE NO. CITY NO.
PLANS REVIEWED_ (_OKH_NOT OK)
NO PLANS NEEDED
PLANS NEEDED PRIOR TO ISSUANCE OF
ELECTRICAL PERMIT
PERMIT ISSUED TO
PER REQUEST AS PER PLANS NO.
AS APPROVED AND ON F'LE 'N MY OFF'CE
DO NOT ISSUE PERMIT UNT'L CLEARED BY
CHIEF BUILDING 'NSPECTOR
DATE CLEARED BY
CHIEF BUILDING INSPECTOR
STATE NO.
PLANS REVIEWED
NO PLANS NEEDED
PLANS NEEDED PRIOR TO 'SSUANCE OF
PLUMBING PERMIT
CITY NO.
(_OKH_NOT OK)
PERMIT 'SSUED TO
PER REQUEST AS PER PLANS NO
AS APPROVED AND ON FILE IN MY OFFICE
DO NOT 'SSUE PERMIT UNTIL CLEARED BY
CHIEF BUILDING INSPECTOR
DATE CLEARED BY
CHIEF BUILDING INSPECTOR
BY
DATE
PERMIT NO.
B911i4577
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LEGAL DESCRIPTlo.N
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MECHANICAL PERMIT
CITY NO.
PLANS REVIEWED_ (_OK) (_NOT OK)
NO PLANS NEEDED_
PLANS NEEDED PRIOR TO ISSUANCE OF
MECHANICAL PERMIT
PERMIT ISSUED TO
PER REQUEST AS PER PLANS NO.
AS APPROVED AND ON FILE IN MYQFFICE
DO NOT ISSUE PERMIT UNTIL CLEARED II'Y
CHIEF BUILOING 'NSPECTOR
DATE CLEARED BY
CHIEF BUILDING INSPECTOR
II'Y
DATE
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R.E PORT & ASSOCIATES
LAND SURVEYING
12395 W. 53rd Ave. Suite G.O(j
Arvada. Colorado 8000L
(303)420-4788
IMPROVEMENT LOCATION CERTlFICAr~.
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DATE ol-lo-il?FEESol5.00 JOB~ 85-1811
MORTGAGE CO. B.A. Hor tg&ge CO.
ADDRESS 3019 Eaton Street
BORROWERS NAME Starker
LEGAL DESCRIPTION
ILot 1 ~ and 14 810ck 6 01 i ngerl
Gardens Subdivision Jefferson
Co. eol,rado
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On the basis of my knowledge, infonnation and belief,
I hereby certify that this improvement location certificate was prepared for
B.A. Hortgag. Co. . that it is not a Land Survey
Plat or Improvement Survey Plat. and that it is not to be relied upon for the establishment of
fence, building, or other future improvement lines. I further certify that the improvements on the
above described parcel on this date. except utility connections, are entirely within the boundaries
of the parcel, except as shown, that there are no enefioa m upon the described premiaea by
improvements on any adjoining premises. except a ~i '~d tha~ tpere is no apparent
,widenee or silfll of any easement crobsing or burde ..id eel, except as noted.
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Recorded at
RECORDED IN
COUNTY OF JEFFERSON
STATE OF COLORADO
RECEPTION NO. 85041218
05/03/85 11:05 8.50
FILING STAMP
o'elo('k--M.,
Reception No.
THIS DEED, Made this 26th
day of
APRIL
1985 . between
RITA COLLEEN KENNEDY
of the
County of JEFFERSON
and State of
('olorado, of the first I?art, and
WILLIAM J. STARKER
/-
whose legal address is ~019 EATON STREET \ DENVER, CO. 80214
..rthe. County of Jeffe~On and State of Colorado, of the second part:
WITNESSETH, That he said pal'ty of the fir:;t part, for and in consideration of the sum of
FIFTY FIVE THOUSAND AND NOjlaO------------------______________________ DOLLARS.
to the said party of the first part in hand paid by the said party of the second part, the receipt whereof is hereby
\'onfessed and acknowledged, has granted, bargained, sold and conveyed, and by these presents does grant. bargain.
.'iell, convey and confirm, unto the said part)' of the second part, his heirs and assigns forever, all the following
(j;,'scribed lot or parcel of land, situate, lying and being- in the
County of Jefferson and State of Colorado, to-wit:
Lots 13 and 14, Block 6
OLINGER GARDENS SUBDIVISION
COUNTY OF JEFFERSON,
STATE OF COLORADO
also known as street and number
3019 EATON STREET,
DENVER, CO. 80214
TOGETHER with all and singular the hereditaments and appurtenances thereto belonging, or in anywise apper-
taining, and the reversion and reversions, remainder and remainders, rents, issues and profits thereof: and all the
estate, right, title, interest, claim and demand whatsoever of the said party of the first part, either in law or equity, of,
in and to the above bUlxained premi~e:-;, with till' lll.l't-ditaments and appurtenances.
TO HAVE ANI> TO HOLD the said prellli:-;l'~ ahove baq:~.ailled and described, with the appurtenances, unto the said
party of the sel'ond part, his heil's and ussiJ.:'ns forever. And the said party of the first part, for himself, his heirs,
executors, and administr'utors, does eov(:,llant, grant, bargain, and agree to and with the said party of the second part,
his heirs and assigns, that at the time of the ensealing and delivery of these presents, he is well seized of the premises
above conveyed, as of good, sure, perfect, absolute and indefeasible estate of inheritance, in law, in fee simple, and has
good right, full power and lawful authority to g-rant, barg-ain, sell and convey the same in manner and form as
aforesaid, and that the same are free and clear from all former and other grants, bargains, sales, liens, taxes,
assessments and encumbrances of whatever kind or nature soever. except the general taxes for
the current year and subsequent years, easements, restrictions, reservations
covenants and rights of way of record, if any,
and the aboved bargained premises in the quiet and peaceable possession of the said party of the second part, his
heirs and assigns against all and every person or pen;ons lawfully claiming or to claim the whole or any part thereof,
the said party of the first part shall and will WARRANT AND FOREVER DEFEND, The singular number shall
include the plural. the plural the singular, and the use of any gender shall be applicable to all genders,
IN WITNESS WHEREOF, the said party of the first part has hereunto set his hand and seal th.e'day and year first
above 'Yrittf;.~.", ) /} J/ "
'0' ,'-~~~'Y';" " Ii /
/'>.>' .....-: It (SEAL)
~,j~ ",~_:::..,~b;'~._~
....,,'v..r,~....
..... \1 i A 11 r\ A. ~ [SEAL]
- . ,I . . _ I .-
:~.:-";r:" ~ ~-:.:." 1) :'
:"" \ j~ II D \ \ ll.: . :;1'. ISEAL]
. ., .' .. () .::,~,
::. ~~ ..... ,~iJ.;.1>~'l# <;ll. ORADO I
Ci~~ ~;i!~~'~:~?~tl~t'l of Denver "
.., I." 'I Ill' \ I'" ~.~---.,.
The foregol~strument was acknowledged before me this 26th day of APRIL
19 85hy
Rita Colleen Kennedy
My commission expires February 11, 1987
~
7125 W. JEFFERSON AVE. SUITE 480
No.932A. W.\J{J{.\;>;TY Iln:1l
DEPARTMENT OF PLANNING & DEVELOPMENT
REQUEST FOR PUBLIC WORKS REVIEW
Date: ~....2G-'11
Location: ~(Cr G~ U
Case/Building Permit No. 13,:,/ /i t/-5 '/7
Please review the attached materials submitted in application for approval
cf a , and indicate your decision on those items
check below, and please add any other comments which you may have under
number 16.
1. C] Boundary Closure:OOK DNot OK; refer to Stipulations
2. C~ Area: Acres Square Feet
3. . C:J Drainage:
a. Drainage plan (and report) needed CJ
b. Drainage Plan not needed 0
c. Drainage provisions have been reviewed and are found to
be: 0 OK 0 Not OK; refer to Stipulations
4. [~ Legal Description: OOK o Not OK; refer to Stipulations
If not okay. please explain:
./
5,. drPublic Improvements: i5 ~
a,. Street Paving needed Y b. Curb & Gutter needed Y
c. Sidewalk needed Y d. Street Lights needed Y
e. Storm Sewer needed Y f. Escrow required Y @ If
Escrow required, for what improvements? In what amount?
6.1_1
Development Agreement required
If Yes, for
Y
N
7. [::1 All necessary documents have been initiated by Public Works and are
attached hereto:
8. c~
Is a traffic impact analysis and report required? Y
N
9. CJ New roadway or alley R.O.W. dedication is recommended:
If yes, what is recommended:
lO.CJ All existing dedicated roadways and alleys meet the standards of
the City:
If no, which do not and what is requested:
11.1~ All existing and proposed dedications have been reviewed and found
to be: CJ OK 0 Not OK; refer to numbers 8 & 9.
12.~~proval: The Public Works Department has reviewed this request
and hereby gives its approval, subject to the above and/or attached
stipulations.
13. CJ
Signat
The Public Works D rtment has reviewed this
approve for the reasons stated:
,~~A\
request and does
not
Signature
14. CJ Stipulations attached:
Date
Yes
No
15. CJ DEADLINE DATE FOR PUBLIC WORKS DEPARTMENT REPLY:
15.
Summary Comments: Ro.9J ,i"",1
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