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Home My WebLink About3250 Benton StreetPERMIT DRESS:�/DB CODE: INSPECTION RECORDh 5 Inspection online form: http://www.cl.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 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 I 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 I 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 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 Co , nts 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 410 Final Window/Door 411 Landscape/F ark/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. `ZC,j 16 11�9 Z �Z� C l�'nfr,qtr k�F The City of Wheat Ridge 114'd Third Party Form Check List Property Address Permit Number Permit Issued Date Owner Information Property Owner Information Property Owner Address Inspection Company Inspector Name Inspector Contact info. 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 Ci Wheat Ridge Policies and Procedure and Manufacturer's recommendati sd s ecifications. 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 Wheat Ridge Building 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 F The City of Wheat Ridge Third Party Form Check List Property Address�� Permit Number G -i qq7 - Permit Issued Date i r1 - L -t - LD I Owner Infornnation Property Owner Information Q�,� Property Owner Address'z, �ZS t�7 1 0 C -D Inspector Information Inspection Company . Inspector Name Inspector Contact info. -G - Inspector Statement and Acknowledgement I hearty acknowledge the roof I am inspecting is 6/1.2 or over all roofs that are under 6/12 must be inspected by the City of Wheat Ridge Buiding Dept. * I Nearby 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 Manufacturers recommendatio nd ecifi ations. j Inspector: Date: roperty 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-paAy ins 'on c any to perform my roof inspection in lieu of the City of ed�'t�Wection. Propery Owner/ Ag Date: /",0,/// 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 Permit counter 2nd floor 7500 W. 29th Ave Wheat Ridge CO 80033 Drafted Date: 7126/17 Submit via Email Please add note to reverse side 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 [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 permit description (Valuation must be adjusted) 9114/A ❑ Pass ❑ Fail Verify sheahing nail pattern ( See policy & Proceedures) ±'N/A Pass [I Fail Crickets and saddles where needed F-1 N/A ��❑((( Pass [] Fail Verify B vent must have boot same gauge as pipe F1 N/A /�y1 X Pass [] Fail Verify vent caps ❑ N/A Pass ❑ Fail Verify no flashings are damaged or rusted ❑ N/A [Od Pass ❑ Fail Step flashing shall be min. of 4x4 piece per shingle N/A ❑ Pass [] Fail Verify scuppers allow for proper drainage ❑ N/A {� Pass [] Fail Ice and water shield 2' in heated wall spaces ❑ N/A [ Pass ❑ Fail Underlayments must follow 2012 IRC / 2012 IBC ❑ N/A Pass ❑ Fail Verify roof slope for proper drainage ❑ N/A (� Pass [� Fail Dripedge shall have min of 2" overlap ❑ N/A 9 Pass L] Fail Dripedge should extend down min 2" past roof deck ❑ N/A [Pass ❑ Fail Dripedge shall be mechanicaly fastened 12" OC ['N/A ❑ 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 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 CD 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 Shingles Requirements VN/A ❑ Pass [] Fail Metal roof shingles shall not be installed on slope less CiN/A ❑ Pass ❑ Fail 3:12 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" 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 Property Address Permit Number Permit Issued Date The City of Wheat Ridge Third Party Form Check List Z 10,1 �i�i7 Owner Infornnation !1 Property Owner Information OQ-� Property Owner Address lZS bojLA -art r ti&�M (� Inspector lnfo,)rmation Inspection Company Q, �,, Inspector Name Inspector Contact info, 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 recommen Inspector: tions. *1 hearby acknowledge that I am the owner of the bG my consent for the listed tt ird� inspection c p in lieu of the City oof�Q 4 idge g-UNjmt-ir Propery Owner/��g�,�� Date: ilding referenced above and I give any to perform my roof inspection spection. c Date: This original document as well as the roofing check list, must be submitted to the Chief Building Offcal within seven days of the final inspection. Drop off in person Submit via Email Permit counter 2nd floor 7500 W. 29th Ave Wheat Ridge CO 80033 Drafted Date: 7/26/17 Please add note to reverse side A The City of Wheat Ridge Inspection Check List notes Fina! 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 Pass ❑ Fail Verify that no more than 2 layers of shingles exist ❑ N/A f Pass 7 Fail Flashing for roof and walls ❑ Pass [=i Fail If new sheathing is installed verify that it is listed in the permit description (Valuation must be adjusted) 9114/A ❑ Pass ❑ Fair Verify sheahing nail pattern ( See policy & Proceedures) J 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 IX Pass ❑ Fail Verify vent caps N/A Pass ❑ Fail Verify no flashings are damaged or rusted ❑ N/A 9 Pass [] Fail Step flashing shall be min. of 4x4 piece per shingle N/A ❑Pass [J Fail Verify scuppers allow for proper drainage ❑ N/A C1 Pass ❑ Fail lee and water shield Z in heated wall spaces ❑ N/A [] Pass ❑ Fail Underlayments must follow 2012 IRC / 2012 IBC N/A Pass ❑ Fail Verify roof slope for proper drainage ❑ N/A XPass [ Fail Dripedge shall have min of 2" overlap ❑ N/A % Pass Fail Dripedge should extend down min 2" past roof deck ❑ N/A [Pass ❑ Fail Dripedge shall be mechanicaly fastened 12" OC IV, N/A ❑ Pass ❑ Fail 90 LB roil 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 �N/A ❑ Pass ❑ Fail Modified Bitumen, EPDM, TPO min slope 1/4:12 slope 19N/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 NIA ❑ Pass f 1 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 Shingles Requirements IVN/A ❑ Pass [ Fail Metal roof shingles shall not be installed on slope less 3:12 ill.N/A ❑Pass [� Fail Metal valley flashing shall be the same material as roof ❑ Pass J 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" Tile Roofs Requirements eN/A ❑ Pass ❑ Fail 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 A'd Third Party Form Check List Property Address r — Permit Number Permit issued Date Omer Information Property Owner Information Property Owner Address Inspection Company Inspector Name Inspector Contact info. Inspector Statement and Acknowledgement * I Nearby 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. * 1 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 C Wheat Ridge Policies and Procedure and Manufacturer's recommendati sabd s ecifications. Inspector: Date: Property Owner Statement of Acknowledoement *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 Wheat Ridge Building 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: 7126/17 Please acrd note to reverse side The City of Wheat Ridge Inspection Check List notes Final Roof Motes Company Name: Inspector signature: ®ate of Inspection: A t City of Wheat Ridge _�r9rCommercial Roofing PERMIT - 201707992 PERMIT NO: 201707992 ISSUED: 10/04/2017 JOB ADDRESS: 3250 Benton ST EXPIRES: 10/04/2018 JOB DESCRIPTION: Commercial Reroof remove and install owens corning duration storm asphalt shingles with 204sq pitch=5/12 *** CONTACTS *** OWNER (303)523-2134 PANAORAMA HEIGHTS 001 SUB (970)691-0845 Brendan O'Keefe 170521 Roof Source LLC *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 102 / BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 101,219.28 FEES Total Valuation 0.00 Use Tax 2,125.60 Permit Fee 1,144.95 ** TOTAL ** 3,270.55 *** COMMENTS *** *** CONDITIONS *** In order to pass a final inspection on commercial elastomeric or similar type roofing, a letter of inspection and approval from the manufacturer technical representative stating that "the application of the roof at (project address) has been applied in accordance with the installation instruction for (roof material brand name) roof covering" is required to be on site at the time of final inspection. Effective December 1, 2014, asphalt shingle installations require an approved midroof inspection, conducted when 25-75 percent of the roof covering is installed, prior to final approval. Installation of roof sheathing (new or overlay) is required on the entire roof when spaced or board sheathing with ANY gap exceeding one half inch exists. Sheathing and Mid -roof inspections may be called in at the same time, 100 percent of the sheathing must be complete and 25-75 percent of the midroof may be complete. Asphalt shingles are required to be fastened to the roof deck with a minimum of 6 nails per shingle. A ladder extending 3 feet above the roof eave and secured in place is required to be provided for all roof inspections. Roof ventilation is required to comply with applicable codes and/or manufacturer installation instructions, whichever is more stringent. 10 �,' . City of Wheat Ridge Commercial Roofing PERMIT - 201707992 PERMIT NO: 201707992 ISSUED: 10/04/2017 JOB ADDRESS: 3250 Benton ST EXPIRES: 10/04/2018 JOB DESCRIPTION: Commercial Reroof remove and install owens corning duration storm asphalt shingles with 204sq 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,ppermit. I fort attest thaqothe ally authorized to include all entities named within this document as parties to the work to be pertorme all wg trmed is disclosed in this document and/or its' accompanying approved plans and specifications. Signatu of O R orCTOR (Circle one) Date 1. This �t was issued bainformation provided in the permit application and accompanying pians 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 original ermit 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. 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 ranting of a permit shall not be construed to be a permit for, or an approval of, an violation of any provision of any applicable c or y ordman�eggula 'cya this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. City of Wheat dge COMMUNITY 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(a)_ci.wheatridge.co.us FOR OFFICE USE ONLY Date: Plan/Permit # L al 761) '07 ��Z Plan Review Fee: 3zw, Building Permit Application *** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: Property Owner (please print): Dn_uca, t(_ ((/y__v%e_ Phone: '3o'3, --6Z_3 -7,(3q Property Owner Email: b v'l C l 68,e _C2 L t Covin Mailing Address: (if different than property address) Address: City, State, Zi Architect/Engineer: Architect/Engineer E-mail: Contractor: 1 Phone: Contractors City License #: Phone: q jQ -' (j0 `j (-0 �sLt(7_ Contractor E-mail Address: Sub Contractors: Electrical W.R. City License # 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 OMMERCIAL ❑ RESIDENTIAL pescription of work: (Check all that apply) ❑ NEW COMMERCIAL STRUCTURE ❑ LECTRICAL SERVICE UPGRADE F1 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 ❑ 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.) Sq. Ft./LF Amps Btu's �-)0 Gallons Squares Other Project Value: (Contract value or the cost of all materials and labor included in the entire project) $ /n/ 7 r C4 Z 57-0 c>_ K/-11 OWNEWCONTRACTOR 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 1 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. 1, the applicant for this building permit application, warrant the truthfulness of the information provided on the application. CIRCLE ONE: (OWNER) (CONTRACTOR) or (AUTHORIZE REPRESENTATIVE) of (OWNER) (CONTRACTOR) /l' Signature (first and last name): \ DATE: 1 i DEPARTMENT USE ONLY ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: OCCUPANCY CLASSIFICATION: Building Division Valuation: $ T aDDIt70yAk PRD�J1¢StONS- Unless otherwise specified herein, the following additional provisions are expressly real ett Oi -to'ft permits wih he paid for by a*", .and obl*,Aw L, -' "I A, other ctfarges. tales, assessrn¢,Ks, fees etc , of any k,,v '+or, required by any trni-nmertt body.. telephone or utility romp .- hie siall be pied for by Comer >taisatlon, cooara[tor has ihrright to'Utuctra'Acl any part of rr ani ot, 'r.e '.r,a herrn 3 Change, Orders. Shosfn Owner, cons radio', lender, or arty goon nment .,dyer , moectw "wee ar+y tiodrfitation to the on cO t ed do bits .,tract- any cast incurred by Contractor viii• be added to the w trait tC as —a wort and Owner agree•%to jay Contractor his norrvl selling •.'e. fir Spf_h24,a.x X AV extra *v,k "war, asanv.FSRe xxf,hrah.r- % thin bTt>jdW co itract shati be Specified and approved try beth Pal nrs in a +•^etc, chance alder Apt chirIIrorders shall bewme a part of this coistract '.f viae, be tncoryorated to er.. I Owner's pzapo"b sty: tnniraitce nits Ow,r+cr is rcsisanub!e to. the nu 'arra(I1) ba see teat *4 • esury water '4ftialcal i>!n>eC aE(vc•. to and tco`et Jxi:,M es are wesvded art Urn preauses f}) to Prnrde a .vase area cit tr•r, covo,,,s'es rva eal,Ort enl and matervats n3) to mlxatc^ 4 vrotert arrr stn+ that fns!, -e nes i muactsv from to rig tre< . <css to r ixskaarss s'.M* as !r sr'n�t :am>tet to TS• or rad+o antrnnns. Lefucles, a0 w gide, eve,oz that Owner 4is to-relmatt7 such :"h5 C^rstractra May =tl_xA¢ thirke Rein+ a., reeu,e d bo In tto gray ,. �r+-a. •r -z^ ._ n thrse +€ems dur,•sg sins, retntattoo - -. tar to cbta+a prrr+ssion tram the Cntr::ii r r•vsst.use-ta gam access and to i:ctd c4Mractor t;n f`C:m thv w art Jdfawn' ++stns deeecls .rich art- . :. rr-siz `,assn no 43ti,hty _.a to, des rot. .. - ;erty VisoranC+' ardal,rm and _ - to tha cerrtracI ti," crorct „ theft or r•andaks+n. ar+y r;/x P oubroan se.." re,ohr,♦; dr •,^2.v els :.*c prci,^c ina.; be pa:d+<y.. . SLOolay- Cc rtr.eZV s*W11 not be h2 : s•��r dx,r317e err' ":4xetd.rh O*-,xy3. raze."ria 1mot wc'• :•xr: i,icgntr.x::,,:. sa:ra wart acs: of more* or a.,e>Irr n. a,..: :r,s fa!ure cf r, -,.ter, iw,atx thre#y pragresa afy°rte+rts e>-payme^ts fur noir, work sNn'".,z,e_, n' atz•xsa.arsr,,a'er iv3Lr. had weatf+tx. ft9e. strMe, war. govern„me:�.t rri°„�:, o,' aro rdfier e�ttesgrrss:t::nrurssnre, by-forira • - , ,.. '.^ntraCnl4 rCaSt-Y.irJts LCti."frF.. fr.St/pffet#'idtYailt and S111WIP. An'f 5ur01ctl matte, al r"�rMr ”, 'Feet' Ccnyfeted are t" of operty of f,;^.",. - "'d ;; r"• re<�o+r-t by sar*rNo ands A dor Cw:xr an res.:.., ,r, .,•a';, nc1,!^-2'S ?eGYJ.ie fl.' -6 �G9Lra^I S iTa -'°' '-:.r a tf •' 1 , _.i ,. esr3P.4irpt t•oaksee+It-,con•, • - r •ri 7:UtanMP i• A/ae1b1111%'1iP0' cnn'G:•t. r:/,6, cr —d sro*f m atcna'+c, oit""ever zost.o:... a riot G+rrder. crn3t,x Ar, y deer: sr•.e±.;st^,re ;rtf>rw�E:L3, garage arws, or any other ra c� a r-,^ �v£''oeirtrCw natal+ is i#utlOtoita6 r 7C::- .x .,..« .^r.pP=.safe fQri'hfftt/a1Rtµ-i+dntl+-Igdrrb�grtl• ••-Cs 'ts_r, ra .r: derrp dnfttll to KotlCt'prCtl lilat pA!lfMr. 0~11 ersbilf, tae W CwAtactof the g.,. •., ,,r/y �f`-e+.'aY:r, t at the lob sir for the per101f of tune .,c i. <�.. eas, - ::a -.-•,R to -Y, L ,:, .rte err,Pte ;av0, _ eerie z if, ter i•rf,.a- i: a'an c �- =fes•_ ar.rt �.. , .+. , . . e.Gviceafeif Damage a DIV �Rrrt - Gn I „rlr ,Sir MEOW.'. w •r :, .;.r�. .. , .snit w. n r iwn!;o•, r r r n jr•mr[r Vts.s R Natartaus SsA—i'n s `""• ! . e; r+ . t.+ a b:i . 41 lir. ,r l •r r.��t_-i..�. ,... 1 .., la. f::, =r to -too Lvor'kandso-l-vithhald Payment on )abrar ii } •t made nr, ce"t•a: t.s .n r+r" [his contra,. Conte to stop s ,I, a';t! kr P [*a• !r.'s ,d!e untA ata pact . 't tcrnvcd Cvi:uacr•:r s furthdr ta;.u: w!d try O .:rsa4, equrpmrn7 andrer tatrc'>upnie<s or ant's called'sappha 1-1 durml the oeood , . ., arrc3+ a q payments to Cantnci'or for biits les ''nal same fi•.f these same "supp!xri• make demand upo` La•o -, .r - p ,ymem oar,. , may rrraYe such payment , !whiff M Contra= tm at ::' , •, ,cto> I. ^*burse itwar, far 1,+, amcu i at surh rune th;: f)wr �! rr s a,+ r r twits r Qr ass R .er is re. ni s<t.. ios:r ii tr supRi+ers p+tor [desk i, been itled under an [ n<tt4rt[v >>ny an =1n'. nw¢d by Caclub w to it suppll¢A A#S,011ttlCE+,t:�..,.,,r, _ It. annum ca at the bight artotr Jimn Jmi,,%obt of )egat; utoi Jrt[:n, and . bound tc aw:ud pens chooses award the til pmd o, incurred 12. Notice Any norm notice g,rer dC.pw,rcda assn !)f day 33. Arburabcn of pisputes. Any LaMrnversy or diem artsirig or relating to this propasaf/contract, at the breath thereof, be settled by arbitration in accordance with the applicable stiuchon hirfiss" Arbitration Rules of -the American Arbitration Associatton which are in effect at the time the demand for abnra- Uon is filyd. A judgment upon the award rendered by the arbitratior(s) may be entered in any court having jurisdiction there- of. Any arbitration award shall be subject to correction and/or vacation tar the reasons stated in the law. The arbitrator shall award reasonable attorneys tees and expenses to the prevailing party. After being given due notice, should any party fall to appear at or participate in the arbitration proceedings, the arbitrator shall make an award Based upon the evidence presented by the party(ies) who do (does) appear and participate. Notwithstanding Contractor's right to arbitrate, Contractor does not waive any of its lien rights. Venue forarbitration hearings shall be the protect county unless otherwise agreed to by the parties. NOTICE- By initialing in the space below you are agreeing to have any dispute arising out of the matters included rn the "arbitration of disputes" provision decided by neutral arbitration as provided by law and you are giving up any rights you might possess to have the dispute litigated in a court or Jury trial- By initialing in the space below you are gluing up your ludkial rights to discovery and ap. peal unless those rights are specifically, included In the `a bits tion if you refuse to suttmd to ,,b, aft; .r provision, you maybe cannpelled to a unit, r -. .. ,.,t the applicable laws. Your ag+rrmt!n2 Arbitration provision is voluntary. - We have read and understand the!forngohtg and agree to s disputes arising out of the mt(tteri included in the "arbkt'af ll disputes" provision to nrut+.d 8rbittaftoo I Agree to Arbitration r) (Initials of FORM (M) 414-02.1123 XCEL ENERGY 133468 CITY - TOWN OR COUNTY FLOOR ACTION TAKEN o NO SHUT OFF ~APPLlANCE OFF D BOTH APPL, & METER OFF o METER SHUT OFF - HAZARD G #' fr L/ '/!?- COtojDrTlON TO BE CORRECTED AS SHOWN BELOW CREATES AN IMMEDIATE HAZARD. THIS EQUIPMENT MUST NOT BE PUT BACK IN SEFtilCE UNTIL REPAIRS AND A THOROUGH INSPECTION HAVE BEEN MADE BY A QUALIFIED CONTRACTOR. COHTACTYOUR LOCAL BUILDING DEPARTIlENT FOR CODE ANO PERMIT REQUIREMENTS PRIOR 10 PERFORMING REPAIR WORK. SPECI~