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4115 Jay Street
Mr. A i CITY OF WHEAT RIDGE "Building Inspection -Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTI NQT)QE r- Inspection Type: Job Address: Permit Number: `D 0 I S D 11 S`3 Icl (f-14 r— I arta) - S. X'nc ❑ No one available for inspection: Time 9 - a I M PM Re -Inspection required: Yeso When corrections have been made, call for re -inspection at 303-234-5933 Date: S / y j 1? Inspector: _7-6 DO NOT REMOVE THIS NOTICE j 4. i CITY OF WHEAT RIDGE _��9�Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Say - f40v&C Wl` A Inspection Type: :Er a�---- Job Address: ,-1 1 9 _ - �� 4 S + Permit Number: -D ®i ©1 ► S 8 r-, &"L ❑ No one available for inspection: Time - I J @'PM Re -Inspection required: Yes Io When corrections have been made, call for re -inspection at 303-234-5933 Date: �l a[,�/,g Inspector: —_)_LS DO NOT REMOVE THIS NOTICE City of Wheat Ridge Residentail Siding PERMIT - 201801158 PERMIT NO: 201801158 ISSUED: 04/25/2018 JOB ADDRESS: 4115 Jay ST EXPIRES: 04/25/2019 JOB DESCRIPTION: Remove existing vinyl siding and replacing with new vinyl siding. 16 squares *** CONTACTS *** OWNER (303)420-1692 GIBSON PAMELA J SUB (720)707-6963 Michael Lindquist 160047 5280 Exteriors *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 12,498.00 FEES Total Valuation 0.00 Use Tax 262.46 Permit Fee 251.85 ** TOTAL ** 514.31 *** COMMENTS *** *** CONDITIONS *** **A MID -INSPECTION IS REQUIRED FOR HOUSE WRAP PRIOR TO SIDING INSTALLATION. A final inspection is required at completion. Work shall comply with 2012 IRC and ordinances adopted by the City of Wheat Ridge. Work is subject to field inspections. A mid -inspection is required for house wrap prior to siding installation. A final inspection is required at completion. City of Wheat Ridge Residentail Siding PERMIT - 201801158 PERMIT NO: 201801158 ISSUED: 04/25/2018 JOB ADDRESS: 4115 Jay ST EXPIRES: 04/25/2019 JOB DESCRIPTION: Remove existing vinyl siding and replacing with new vinyl siding. 16 squares Ib, 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 a leggally authorized to include all entities named within this document as parties to the work to be performed a hat alI �,grk to: be p riormed is disclosedn this document and/or its' accompanying approved plans and specifications. Signatur of OWNER or CONTRACTOR (Circle one) Date 1. This permit was issued based on the information provided in thepermit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, po plans 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 and procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a 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 i ce or gr!! f a permit shall not be construed to be a permit for, or an approval of, an violation of any provision of any appl a co or any , finance 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. City Of WheatR COMMUNITY DEVELOPMENT Building & Inspection Services Division 7500 W. 2911 Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: permits ccDci.wheatridge.co.us FOR OFFICE USE ONLY Date: Plan/Permit # L A,/ P D 1 Plan Review Fee: 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): ��,� J C 5 6 r-" Phone: 30`3 - Property Owner Email: CA Tenant (Commercial Projects Only) Property Owner Mailing Address: (if different than property address) Address: City, State, Zip: Architect/Engineer: �J JA Arch itect/Eng1neer E-mail: Phone: C C) "-K) Contractor: EXquiSt �g-C�� City of Wheat Ridge License #: ip b L7 �{ Phone: 3 0-3 `�� S I CEJ Contractor E-mail Address:_ ! v( c�j Sages ��C�-e ft Qr5 , (-Orn For Plan Review Questions & Comments (please print): CONTACT NAME (please print): M 4 L_( tjiqo i i 5' I Phone: go -3 S 106 CONTACT EMAIL(p/ease print): Sub Contractors (Must provide WtIpat Ridge License No.): Electrical: E L'lumbing: Mechanical: W.R. City License # W.R. City License # W.R. City License # APR 2-f Other City Licensed Sub: Other City Licensed Sub: City License # N City License # ❑COMMERCIAL U 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. pq Lc(I'l W1 Ae Commercial Projects Only: Occupancy Type: Construction Type: Sq. FULF Amps BTUs Gallons Squares Project Value: (Contract value or the cost of all materials and labor included in the entire project) 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) or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) Signature (first and last nam/e)::':yC///ty Printed Name: / (( / Gtz L -r, ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer. PUBLIC WORKS COMMENTS: Reviewer: DEPARTMENT USE ONLY DATE: y-;,) o5 - OCCUPANCY CLASSIFICATION: CONSTRUCTION TYPE: Building Division Valuation: /1 ntt�Sys q 1�,_TSt. INSPECT ON RECORD INSPECTLON ONLINE FORM: http://www.ci.wheatridge.co.us/inspection INSPECTION REQUEST LINE: (303) 234-5933 Occupancy/Type Inspections will not be performed unless this card is posted on the project site. **Request an inspection before 11:59 p.m. (midnight) to receive an inspection the following business day.** Inspector Must Sign ALL Spaces pertinent to this project Foundation Inspections Date Inspector Comments Initials Pier Concrete Encased Ground (CEG) Foundation / P.E. Letter 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 Approval Of The Above Inspections Rough Inspections Date Inspector Initials Comments WaIrSheathing Landscaping & Parking / Planning Dept. Mid -Roof Inspections from these entities should be requested one week in advance. For landscaping and parking inspections call 303-235-2846. For ROW and drainage inspections call 303-235-2861. For fire inspections contact the Fire Protection District for your project. ROW & Drainage / Public Works Dept. Lath / Wall Tie Floodplain Inspection (if applicable) Rough Electric Fire Inspection / Fire Protection Dist. Rough Plumbing/Gas Line Final Electrical Rough Mechanical Rough Framing Rough Grading Final Mechanical Insulation Roof Drywall Screw/ Nail Final Inspections Date Inspector Initials Comments Landscaping & Parking / Planning Dept. Inspections from these entities should be requested one week in advance. For landscaping and parking inspections call 303-235-2846. For ROW and drainage inspections call 303-235-2861. For fire inspections contact the Fire Protection District for your project. ROW & Drainage / Public Works Dept. Floodplain Inspection (if applicable) Fire Inspection / Fire Protection Dist. Final Electrical Final Plumbing Final Mechanical Roof (4 Final Window/Doors Final Building NOTE. All items must be completed and approved by Planning, Public Works, Fire and Building before a Certificate of Occupancy is issued. Approval of the Final Building inspection does not constitute authorization of occupancy. *For low voltage permits — Please be sure that rough inspections are completed from the Fire District and electrical low voltage by the Building Division. Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued Protect This Card From The Weather J City of Wheat Ridge Residential Roofing PERMIT - 201705488 PERMIT NO: 201705488 ISSUED: 08/04/2017 JOB ADDRESS: 4115 Jay ST EXPIRES: 08/04/2018 JOB DESCRIPTION: Residential Re -roof to install GAF Timberline HD asphalt shingles with ROOF DECKING - 22 sq *** CONTACTS *** OWNER (303)420-1692 GIBSON PAMELA J SUB (720)708-4126 Terry Marks 130138 Home Guard Services LLC *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 7,372.75 FEES Total Valuation 0.00 Use Tax 154.83 Permit Fee 172.60 ** TOTAL ** 327.43 *** COMMENTS *** *** CONDITIONS *** Effective December 1, 2014, asphalt shingle installations require an approved midroof inspection, conducted when 25-75 percent of the roof covering is installed, prior to final approval. Installation of roof sheathing (new or overlay) is required on the entire roof when spaced or board sheathing with ANY gap exceeding one half inch exists. Sheathing and mid -roofs may be called in at the same time, one hundred percent of the sheathing must be complete and 25-75 percent of the mid -roof may be complete. Asphalt shingles are required to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield is required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave and secured in place is required to be provided for all roof inspections. Roof ventilation is required to comply with applicable codes and/or manufacturer installation instructions, whichever is more stringent. In order to pass a final inspection of elastomeric or similar type roof coverings, a letter of inspection and approval from the manufacturer technical representative stating that "the application of the roof at (project address) has been applied in accordance with the installation instruction for (roof material brand name) roof covering" is required to be on site at the time of final inspection. Roof inspections for ROOFS OVER 6/12 PITCH: 3rd party inspection will be required, the 3rd party inspection report will be collected at final roof inspection performed by City of Wheat Ridge. If report is not available the final inspection will not be completed. City of Wheat Ridge Community Development Department Memorandum TO: Accounting Department FROM: Kim Cook, Building Division SUBJECT: Refund for Permit DATE: August 22, 2017 Reason: Customer pulled duplicate permits and paid for both. Contractor requested to have permit #201704646, for 4115 Jay Street closed out. Please refund: Contractors License$ (acct 01-510-00-513) 80% permit fee: $ 112.72 (acct 01-510-00-516) 0% plan review $ (acct 01-550-05-551) 100 % use tax: $ 118.73 (acct 01-500-02-505) Total: $ 231.45 TO: Homeguard Service LLC 6850 W. 52nd Avenue #106 Arvada, CO 80002 Thank You! Permit Technician (ITW003� ttx - 1103 No"To lQ11 city of Wheat ice C COMIv1[IN11Y DEVELOPMENT, City of Wheat Ridge Municipal Building 7500 W. 291h Ave. Wheat Ridge, CO 80033-8001 P: 303.235.2855 F: 303.237.8929 Refund Application Complete this application in its entirety, attach all copies of permits, permit cards (if issued) and receipts that were received at the time of permit issuance. Requests for more than 80 percent of the amount paid will not be approved without prior approval from the Building Official. The refund application must be received by the Wheat Ridge Building Division no later than 180 days after permit issuance. Applications received after 180 days of permit issuance will not be approved. You can mail or hand -deliver all required documents to: City of Wheat Ridge, Attn: Building Division, 7500 W. 29th Ave., Wheat Ridge, CO 80033. Company Name/Name (to whom check should be made out to): V�Nmp'quw LLL Address: l Q Il �) b %,w lrjt nd \ u City: NYV(SU, State: W Zip: 00CW 2 Permit #: 'LO t -100 l9 Q (p Permit Address: Lt � 1 Cj 6�(.lm Ck . Reason for request: Printed Name: r{ !l (�Jk(AX44 Signature: Date:0-1 For office use only 9�/ This request has beApproved ElDenied Refund Amount: $t C Approved by: en / Date: / www.ci.wheatridge.co.us r City of Wheat Ridge . ' Residential Roofing PERMIT - 201704646 PERMIT NO:, 201704646 ISSUED: 07/24/2017 JOB ADDRESS: 4115 Jay ST EXPIRES: 07/24/2018 JOB DESCRIPTION: Residential Re -roof to install GAF Timberline HD asphalt shingles with 22 sq. *** CONTACTS *** OWNER (303)420-1692 GIBSON PAMELA J SUB (720)708-4126 Terry Marks 130138 Home Guard Services LLC *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 5,654.00 FEES Total Valuation 0.00 Use Tax 118.73 Permit Fee 140.90' ** TOTAL ** 259.63a, *** 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 one half 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 manufacturer installation instructions, whichever is more stringent. In order to pass a final inspection of elastomeric or similar type roof coverings, a letter of inspection and approval from the manufacturer technical representative stating that "the application of the roof at (project address) has been applied in accordance with the installation instruction for (roof material brand name) roof covering" is required to be on site at the time of final inspection. Roof inspections for ROOFS OVER 6/12 PITCH: 3rd party inspection will be required, the 3rd party inspection report will be collected at final roof inspection performed by City of Wheat Ridge. If report is not available the final inspection will not be completed. ti � A a City of Wheat Ridge T Residential Roofing PERMIT - 201704646 PERMIT NO: 201704646 ISSUED: 07/24/2017 JOB ADDRESS: 4115 Jay ST EXPIRES: 07/24/2018 JOB DESCRIPTION: Residential Re -roof to install GAF Timberline HD asphalt shingles with 22 sq. 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 pthis ermit. I further attest that I am legally authorized to include all entities named within this document as parties to the work to be ined and that all�vork;te be peroy�ned is disclosed in this document and/or its' accompanying approved plans and specifications. Signature of OWNER or I 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 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 and procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Offial 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 Divisi 6. The issua r ' ' g o 1 not be construed to be a permit for, or an approval of, an violation of any provision of any applica o din on of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Official +r Date REQUEST MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. 101) A Dan Schultz 76V, From: no-reply@ci.wheatridge.co.us Sent: Thursday, July 13, 2017 3:40 PM To: Permits CommDev Subject: Online Form Submittal: Residential Roofing Permit Application Categories: Gina Residential Roofing Permit Application This application is exclusively for new permits for residential roofs and for licensed contractors only. This type of permit is ONLY being processed online --do not come to City Hall to submit an application in person. Permits are processed and issued in the order they are received and due to the volume of requests, time to process varies and is subject to change. YOU WILL BE CONTACTED WHEN YOUR PERMIT IS READY FOR PICK-UP AND WILL BE GIVEN A SPECIFIC DATE AND TIME WINDOW TO COMPLETE THE TRANSACTION. You will be notified if your contractor's license or insurance has expired, and you may update those documents at the time you are issued your permit. For all other requests: Homeowners wishing to obtain a roofing permit must apply for the permit in person at City Hall. Revisions to existing permits (for example, to add redecking) must be completed in person at City Hall. All other non -roofing permits must be completed in person at City Hall. The Building Division will be open from 7:30-10:30 a.m., Monday through Friday to process these types of requests. THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN REROOFING UNTIL PERMIT HAS BEEN ISSUED. Is this application for a Yes residential roof? How many dwelling units Single Family Home are on the property? PROPERTY INFORMATION Property Address Property Owner Name Property Owner Phone Number Property Owner Email Address 4115 Jay St Pam Gibson 303-420-1692 Field not completed. Do you have a signed Yes contract to reroof this property? It will need to be provided at the time of permit pick-up. CONTRACTOR INFORMATION Contractor Name Contractor's License Number (for the City of Wheat Ridge) Contractor Phone Number HomeGuard Restoration 130138 7207084126 Contractor Email Address ROXANNET@HOMEGUARDRESTORATION.COM Retype Contractor Email ROXANNET@HOMEGUARDRESTORATION.COM Address DESCRIPTION OF WORK Are you re -decking the No roof? Description of Roofing GAF Timberline HD Material Select Type of Material: Asphalt If "Other" is selected Field not completed. above, describe here: / How many squares of the 22 V/ material selected above? Does any portion of the property include a flat roof? If yes, how many squares on the flat roof? No Field not completed. TOTAL SQUARES of all 22 roofing material for this project Provide additional detail Replacing house roof and gazebo here on the description of PkI 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) -see,- S � 4 - 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 Roxanne Porter Email not displaying correctly? View it in your browser. 3 SURETY AND ABILITY INSURER INFORMATION Creratf fAi�ni�gers"i2iif,2xi +3b r/ BBB r3 .� art#i�orrr�xr +,�frr �fem�ra�r5rsfcri � � ° / �� / // / i - - ' i , ,. , 'u, K rAld y a u.. i, r . i ypo: r irN%r, , , RV:Ji"#3SV SYSTEMS' ElwiS U—NIAK W, Raw*u` urrar w�rra�ty i . 5d�ar�sur �_ "��s € � � r �!-p�rar �ar�t� pbtky � nr,usPtan rnanafzraurerz�arranrs �. r s� 100-044 lh," p n1 r ti#W�iL AREAitW4AA a a mom, / K b, .rgr3s, t / t ,,. 9Y L r'P i%�+d3 j"tYfl i ✓ £' ' „'' .. ",Pad er siosAj(Ance, � '4 //o � /itis ✓ r r '+" WOMr v P n{ �r W 1 , ext t�5i� reWrt WAs a r i i r s� r to ar g } rrrrcer s� 6eia es r MA n (4£ on tfie ers� ,� Aprtroxir#rate Start atc n „ ��� r,,, r, ,i� ..,,✓/ i "�r ��r�r+arrrpany. „ , WA ewer �'��- 9GHT G CAaELLATit'H t T7 EEiEf' El%; it3t- iL. E TAT, -33; Yli, TiE ii', iAY GAtVCE 3 E 7THIRD BUESS DAY AFTER, fIRCE)ATE OF TTI TRANIA TIO SEE ATTACHE GT GE AGE ATIi k Et t EC i A E i LA ATION OF THN R GHT t1G 1T E A iGELLATIi t SibA GGA. .3 2=- YOU THEU;�AANCES, THIS AGREEMENT T ANY TWE Wi i l 72 H 3 R5 AFTE 2 iJ iA l , E1 it3Tl E 1 UH INSURE HAS Ef TO PAY FOR THE IGOODS A*D SERVIf,ES TO SE,PROVIDED UNDER THIS AWOOEE� SEE ATTA E ' OTICE E CANCELLAT40N FORM FOR AN EXPLANATION OF THIS RIGHT. QmVia, shah had in trust any pomfrom Gua r nsW1 {Aiparry has de'r4dih�ts to your property or has performed a majority of the work on the propa , � ® d City of Wheat Ridge 1W r Residential Roofing PERMIT - 201705488 PERMIT NO: 201705488 ISSUED: 08/04/2017 JOB ADDRESS: 4115 Jay ST EXPIRES: 08/04/2018 JOB DESCRIPTION: Residential Re -roof to install GAF Timberline HD asphalt shingles with ROOF DECKING - 22 sq *** CONTACTS *** OWNER (303)420-1692 GIBSON PAMELA J SUB (720)708-4126 Terry Marks 130138 Home Guard Services LLC *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT*: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 7,372.75 FEES Total Valuation 0.00 Use Tax 154.83 Permit Fee 172.60 ** TOTAL ** 327.43 *** COMMENTS *** *** CONDITIONS *** Effective December 1, 2014, asphalt shingle installations require an approved midroof inspection, conducted when 25-75 percent of the roof covering is installed, prior to final approval. Installation of roof sheathing (new or overlay) is required on the entire roof when spaced or board sheathing with ANY gap exceeding one half inch exists. Sheathing and mid -roofs may be called in at the same time, one hundred percent of the sheathing must be complete and 25-75 percent of the mid -roof may be complete. Asphalt shingles are required to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield is required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave and secured in place is required to be provided for all roof inspections. Roof ventilation is required to comply with applicable codes and/or manufacturer installation instructions, whichever is more stringent. In order to pass a final inspection of elastomeric or similar type roof coverings, a letter of inspection and approval from the manufacturer technical representative stating that "the application of the roof at (project address) has been applied in accordance with the installation instruction for (roof material brand name) roof covering" is required to be on site at the time of final inspection. Roof inspections for ROOFS OVER 6/12 PITCH: 3rd party inspection will be required, the 3rd party inspection report will be collected at final roof inspection performed by City of Wheat Ridge. If report is not available the final inspection will not be completed. i A City of Wheat Ridge Residential Roofing PERMIT - 201705488 PERMIT NO: 201705488 ISSUED: 08/04/2017 JOB ADDRESS: 4115 Jay ST EXPIRES: 08/04/2018 JOB DESCRIPTION: Residential Re -roof to install GAF Timberline HD asphalt shingles with ROOF DECKING - 22 sq 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 legall uthorized to include all entities named within this document as parties to the work to be perform and that all wor perfo d is disclosed in this document and/or its' accompanying approved plans and specifications. 7 Signal of OWNER or C 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 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 and procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of amanner shall be performed that shall results in a change of the natural flow of water without prior and specific approval. 5. The permit ho lnyder 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 applicably,. 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. Dan Schultz 2ol7a1iyO From: no-reply@ci.wheatri dge.co.us Sent: Friday, July 28, 2017 11:20 AM To: CommDev Permits Subject: Online Form Submittal: Residential Roofing Permit Application Categories: Dane Residential Roofing Permit Application This application is exclusively for new permits for residential roofs and for licensed contractors only. This type of permit is ONLY being processed online --do not come to City Hall to submit an application in person. Permits are processed and issued in the order they are received and due to the volume of requests, time to process varies and is subject to change. YOU WILL BE CONTACTED WHEN YOUR PERMIT IS READY FOR PICK-UP AND WILL BE GIVEN A SPECIFIC DATE AND TIME WINDOW TO COMPLETE THE TRANSACTION. You will be notified if your contractor's license or insurance has expired, and you may update those documents at the time you are issued your permit. For all other requests: Homeowners wishing to obtain a roofing permit must apply for the permit in person at City Hall. Revisions to existing permits (for example, to add redecking) must be completed in person at City Hall. All other non -roofing permits must be completed in person at City Hall. The Building Division will be open from 7:30-10:30 a.m., Monday through Friday to process these types of requests. THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN REROOFING UNTIL PERMIT HAS BEEN ISSUED. Is this application for a Yes residential roof? How many dwelling units Single Family Home are on the property? PROPERTY INFORMATION Property Address Property Owner Name Property Owner Phone Number Property Owner Email Address 4115 Jay St 0 L Pam Gibson 303-420-1692 Field not completed. )rST7,`i3 Do you have a signed Yes contract to reroof this property? It will need to be provided at the time of permit pick-up. Attach Copy of Contact gibson contract.pdf CONTRACTOR INFORMATION Contractor Business Homeguard Roofing and Restoration Name Contractor's License 130138 Number (for the City of L Wheat Ridge) Contractor Phone 7207084126 Number Contractor Email Address fernl@homeguardroof.com Retype Contractor Email fernl@homeguardroof.com Address DESCRIPTION OF WORK Are you re -decking the Yes roof? Description of Roofing GAF Timberline HD Material Select Type of Material: Asphalt If "Other" is selected Field not completed. above, describe here: How many squares of the 22 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 22 (pitched + flat) of all i roofing material for this project 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) Replacing roof on main house and gazebo, we will also re deck the roof. Pitch 5/12 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 Fern Lytwyn Email not displaying correctly? View it in your browser. 3 114 HOMEGUARD aeoflxs s xEsroxsnoN Name: City: _ V1% Project Address: (if different from above) Home# Insurance Company: Sales Representative: Name: Project Manager. Name: Cettk: SURETY AND L ABILITY INSURER INFORMATION Colony Insuran e- Policy Number OTE21366 Contact. GIA Rik Management, (3031423-0162, ext. 136 ` 6850 W 52nd enue Suite 106 Arvada, CO 80002 e_ !T Office: 720 708 126 Fax: 720.921.8658 QW Q"K"i f Site "• info@HomeGu rdRoof.com HomeGuardRoor.com`""""" CUSTOMER INFORMATION Address: "L t 1 � tCMA S+ - - zip: ©� Email: _yAb Claim No: - Deductible- 115(13 ©lzi Phone: 77Q0 9151- 9L`i��—tt7 Phone NEW ROOFING SYSTE SCOPE OF RESTORATION SERI/ICES TO BE PROVIDED STRUCTURES INCLUDED �ain [�7etached Garage 90ther ❑ Manufacturer:_ ❑ Type: T% ❑ Ridge Material: ❑ Undertayment: Leak Barrier Drip Edge Flashing Ventilation Type:_ Color ves s ilii 5i all Chimney T to E]Ridge ElEdge 2Pl bing Boots ly X J r t All Roof Accessories ve trash from roof gutters & yard f lawn & drive with magnetic sweeper Furnish permit ❑ Miscellaneous: _ LOW SLOPE AREAS Material Manufacturer. ADDITIONAL AREAS OF CON! All a-tional areas of construction will be repaired or re Gutters ❑ Paint/Stain ❑ Siding ❑ Windows Notes: "Scope of Restoration Services Provided shall include any additional s This Agreement does NOT obligate the Customer nor Company in ar restoration services to be provided by Customer's insurance compan Agreement, including all terms on the reverse side hereof. Custome Customer Payment is due upon completion of each trade. Compan manufacturer's installation instructions & the }l�ocal budding od s Agreed Price: SVt'Gaal L C c R "S shaft b the o az authorized insurance supplements or as set forth on the reverse side Approximate Dates of Service. Substantial commencement of work subject to any permissible delays as per provision (41 on the reverse s By signing this Afire gent you agree that you have also been provide, _tslaftUWn rat rewetyv approval. I accept the above terms of this cor Approved and accepted lCustomerl Approved and Accepted (Customer) SERVICE AGREEMENTS GAF ROOFING SYSTEMS tUCTION,. SCOPE OF RESTORATION SERVICES TO BE PROVIDED ced with high grade materials of tike kind and quality ; SERVICE AGREEMENT ❑ Interior ❑ Skylight ❑ Other 104 STANDARD Material - Manufacture Standard Workmanship Repair 1 yr Full Replacement 2 yrs pp(ements and services approved by Customer's insurance company and accepted by Company. way unless the insurance claim is approved for repairs or replacement to the above mentioned/written scope of and excepted by Company. Customer's signature below signifies acceptance of all terms and conditions of this 's total out of pocket expenses are not to exceed insurance deductible plus upgrades for non -insurance items. and its authorized representatives are NOT acting as public insurance adjusters. Ali work is installed per the oount due to Company under this Agreement, which is subject to any adds ons and/or deductions pursuant to iereof Total estimated cost of any non -insurance upgrades shaft be: $__ a(t mean either the physicald very of me onto the premises or the performanc any t bor aalt be ie Approximate Start Oate: Approximate Completion Date: notice of this right to cancel orally in addition to a writing contained herein This contract is subject to Compa y ract and authorize Company ed. �l .`'S_` t ' Date ppro ed and Acce d (Companyl Date Date I have received the Things to Remember document Ini i s RIGHT OF CANCELLATION PURSUANT TO FEDER L REGULATION AND COL. REV. STAT. 5-3-403: YOU, THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDN GHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. SEE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. RIGHT OF CANCELLATION PURSUANT TO COL. RE V. ST. 4 6-22-104: YOU, THE BUYER, MAY CANCEL THIS AGREEMENT AT ANY TIME WITHIN 72 HOURS AFTER YOU HAVE BEEN NOTI ED THAT YOUR INSURER HAS DENIED YOUR CLAIM TO PAY FOR THE GOODS AND SERVICES TO BE PROVIDED UNDER THIS AGREE ENT. SEE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. Company shall hold in trust any payment from Customer until Co Impany has delivered the materials to your property or has performed a majority of the work on the property. r r r.•r Material - enetrations 50 -year 50 -year STANDARD �� �•. manufacturer warranty 25 -year service policy manufacturer warranty 10 -year service policy go -yew to -year manufadurorworranty manutacturarwamnty Workmanship 5 yrs Workmanship 2 yrs 5 -year service pa0cy 2 -year Other Non -Prorated Non -Prorated workmanship warranty aon Proraizd ire aim Customer In:tiais Transferrable Transferrabte i anste ratite ROOF SYSTEM tUCTION,. SCOPE OF RESTORATION SERVICES TO BE PROVIDED ced with high grade materials of tike kind and quality ; SERVICE AGREEMENT ❑ Interior ❑ Skylight ❑ Other 104 STANDARD Material - Manufacture Standard Workmanship Repair 1 yr Full Replacement 2 yrs pp(ements and services approved by Customer's insurance company and accepted by Company. way unless the insurance claim is approved for repairs or replacement to the above mentioned/written scope of and excepted by Company. Customer's signature below signifies acceptance of all terms and conditions of this 's total out of pocket expenses are not to exceed insurance deductible plus upgrades for non -insurance items. and its authorized representatives are NOT acting as public insurance adjusters. Ali work is installed per the oount due to Company under this Agreement, which is subject to any adds ons and/or deductions pursuant to iereof Total estimated cost of any non -insurance upgrades shaft be: $__ a(t mean either the physicald very of me onto the premises or the performanc any t bor aalt be ie Approximate Start Oate: Approximate Completion Date: notice of this right to cancel orally in addition to a writing contained herein This contract is subject to Compa y ract and authorize Company ed. �l .`'S_` t ' Date ppro ed and Acce d (Companyl Date Date I have received the Things to Remember document Ini i s RIGHT OF CANCELLATION PURSUANT TO FEDER L REGULATION AND COL. REV. STAT. 5-3-403: YOU, THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDN GHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. SEE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. RIGHT OF CANCELLATION PURSUANT TO COL. RE V. ST. 4 6-22-104: YOU, THE BUYER, MAY CANCEL THIS AGREEMENT AT ANY TIME WITHIN 72 HOURS AFTER YOU HAVE BEEN NOTI ED THAT YOUR INSURER HAS DENIED YOUR CLAIM TO PAY FOR THE GOODS AND SERVICES TO BE PROVIDED UNDER THIS AGREE ENT. SEE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. Company shall hold in trust any payment from Customer until Co Impany has delivered the materials to your property or has performed a majority of the work on the property. r r r.•r Material - Material - Manufacture Standard Manufacture Standard Workmanship 5 yrs Workmanship 2 yrs )e Out-of-pocket upgrade costs for Customer In:tiais tUCTION,. SCOPE OF RESTORATION SERVICES TO BE PROVIDED ced with high grade materials of tike kind and quality ; SERVICE AGREEMENT ❑ Interior ❑ Skylight ❑ Other 104 STANDARD Material - Manufacture Standard Workmanship Repair 1 yr Full Replacement 2 yrs pp(ements and services approved by Customer's insurance company and accepted by Company. way unless the insurance claim is approved for repairs or replacement to the above mentioned/written scope of and excepted by Company. Customer's signature below signifies acceptance of all terms and conditions of this 's total out of pocket expenses are not to exceed insurance deductible plus upgrades for non -insurance items. and its authorized representatives are NOT acting as public insurance adjusters. Ali work is installed per the oount due to Company under this Agreement, which is subject to any adds ons and/or deductions pursuant to iereof Total estimated cost of any non -insurance upgrades shaft be: $__ a(t mean either the physicald very of me onto the premises or the performanc any t bor aalt be ie Approximate Start Oate: Approximate Completion Date: notice of this right to cancel orally in addition to a writing contained herein This contract is subject to Compa y ract and authorize Company ed. �l .`'S_` t ' Date ppro ed and Acce d (Companyl Date Date I have received the Things to Remember document Ini i s RIGHT OF CANCELLATION PURSUANT TO FEDER L REGULATION AND COL. REV. STAT. 5-3-403: YOU, THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDN GHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. SEE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. RIGHT OF CANCELLATION PURSUANT TO COL. RE V. ST. 4 6-22-104: YOU, THE BUYER, MAY CANCEL THIS AGREEMENT AT ANY TIME WITHIN 72 HOURS AFTER YOU HAVE BEEN NOTI ED THAT YOUR INSURER HAS DENIED YOUR CLAIM TO PAY FOR THE GOODS AND SERVICES TO BE PROVIDED UNDER THIS AGREE ENT. SEE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. Company shall hold in trust any payment from Customer until Co Impany has delivered the materials to your property or has performed a majority of the work on the property. � ® d City of Wheat Ridge 1W r Residential Roofing PERMIT - 201705488 PERMIT NO: 201705488 ISSUED: 08/04/2017 JOB ADDRESS: 4115 Jay ST EXPIRES: 08/04/2018 JOB DESCRIPTION: Residential Re -roof to install GAF Timberline HD asphalt shingles with ROOF DECKING - 22 sq *** CONTACTS *** OWNER (303)420-1692 GIBSON PAMELA J SUB (720)708-4126 Terry Marks 130138 Home Guard Services LLC *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT*: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 7,372.75 FEES Total Valuation 0.00 Use Tax 154.83 Permit Fee 172.60 ** TOTAL ** 327.43 *** COMMENTS *** *** CONDITIONS *** Effective December 1, 2014, asphalt shingle installations require an approved midroof inspection, conducted when 25-75 percent of the roof covering is installed, prior to final approval. Installation of roof sheathing (new or overlay) is required on the entire roof when spaced or board sheathing with ANY gap exceeding one half inch exists. Sheathing and mid -roofs may be called in at the same time, one hundred percent of the sheathing must be complete and 25-75 percent of the mid -roof may be complete. Asphalt shingles are required to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield is required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave and secured in place is required to be provided for all roof inspections. Roof ventilation is required to comply with applicable codes and/or manufacturer installation instructions, whichever is more stringent. In order to pass a final inspection of elastomeric or similar type roof coverings, a letter of inspection and approval from the manufacturer technical representative stating that "the application of the roof at (project address) has been applied in accordance with the installation instruction for (roof material brand name) roof covering" is required to be on site at the time of final inspection. Roof inspections for ROOFS OVER 6/12 PITCH: 3rd party inspection will be required, the 3rd party inspection report will be collected at final roof inspection performed by City of Wheat Ridge. If report is not available the final inspection will not be completed. i A City of Wheat Ridge Residential Roofing PERMIT - 201705488 PERMIT NO: 201705488 ISSUED: 08/04/2017 JOB ADDRESS: 4115 Jay ST EXPIRES: 08/04/2018 JOB DESCRIPTION: Residential Re -roof to install GAF Timberline HD asphalt shingles with ROOF DECKING - 22 sq 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 legall uthorized to include all entities named within this document as parties to the work to be perform and that all wor perfo d is disclosed in this document and/or its' accompanying approved plans and specifications. 7 Signal of OWNER or C 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 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 and procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of amanner shall be performed that shall results in a change of the natural flow of water without prior and specific approval. 5. The permit ho lnyder 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 applicably,. 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. Dan Schultz 2ol7a1iyO From: no-reply@ci.wheatri dge.co.us Sent: Friday, July 28, 2017 11:20 AM To: CommDev Permits Subject: Online Form Submittal: Residential Roofing Permit Application Categories: Dane Residential Roofing Permit Application This application is exclusively for new permits for residential roofs and for licensed contractors only. This type of permit is ONLY being processed online --do not come to City Hall to submit an application in person. Permits are processed and issued in the order they are received and due to the volume of requests, time to process varies and is subject to change. YOU WILL BE CONTACTED WHEN YOUR PERMIT IS READY FOR PICK-UP AND WILL BE GIVEN A SPECIFIC DATE AND TIME WINDOW TO COMPLETE THE TRANSACTION. You will be notified if your contractor's license or insurance has expired, and you may update those documents at the time you are issued your permit. For all other requests: Homeowners wishing to obtain a roofing permit must apply for the permit in person at City Hall. Revisions to existing permits (for example, to add redecking) must be completed in person at City Hall. All other non -roofing permits must be completed in person at City Hall. The Building Division will be open from 7:30-10:30 a.m., Monday through Friday to process these types of requests. THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN REROOFING UNTIL PERMIT HAS BEEN ISSUED. Is this application for a Yes residential roof? How many dwelling units Single Family Home are on the property? PROPERTY INFORMATION Property Address Property Owner Name Property Owner Phone Number Property Owner Email Address 4115 Jay St 0 L Pam Gibson 303-420-1692 Field not completed. )rST7,`i3 Do you have a signed Yes contract to reroof this property? It will need to be provided at the time of permit pick-up. Attach Copy of Contact gibson contract.pdf CONTRACTOR INFORMATION Contractor Business Homeguard Roofing and Restoration Name Contractor's License 130138 Number (for the City of L Wheat Ridge) Contractor Phone 7207084126 Number Contractor Email Address fernl@homeguardroof.com Retype Contractor Email fernl@homeguardroof.com Address DESCRIPTION OF WORK Are you re -decking the Yes roof? Description of Roofing GAF Timberline HD Material Select Type of Material: Asphalt If "Other" is selected Field not completed. above, describe here: How many squares of the 22 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 22 (pitched + flat) of all i roofing material for this project 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) Replacing roof on main house and gazebo, we will also re deck the roof. Pitch 5/12 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 Fern Lytwyn Email not displaying correctly? View it in your browser. 3 114 HOMEGUARD aeoflxs s xEsroxsnoN Name: City: _ V1% Project Address: (if different from above) Home# Insurance Company: Sales Representative: Name: Project Manager. Name: Cettk: SURETY AND L ABILITY INSURER INFORMATION Colony Insuran e- Policy Number OTE21366 Contact. GIA Rik Management, (3031423-0162, ext. 136 ` 6850 W 52nd enue Suite 106 Arvada, CO 80002 e_ !T Office: 720 708 126 Fax: 720.921.8658 QW Q"K"i f Site "• info@HomeGu rdRoof.com HomeGuardRoor.com`""""" CUSTOMER INFORMATION Address: "L t 1 � tCMA S+ - - zip: ©� Email: _yAb Claim No: - Deductible- 115(13 ©lzi Phone: 77Q0 9151- 9L`i��—tt7 Phone NEW ROOFING SYSTE SCOPE OF RESTORATION SERI/ICES TO BE PROVIDED STRUCTURES INCLUDED �ain [�7etached Garage 90ther ❑ Manufacturer:_ ❑ Type: T% ❑ Ridge Material: ❑ Undertayment: Leak Barrier Drip Edge Flashing Ventilation Type:_ Color ves s ilii 5i all Chimney T to E]Ridge ElEdge 2Pl bing Boots ly X J r t All Roof Accessories ve trash from roof gutters & yard f lawn & drive with magnetic sweeper Furnish permit ❑ Miscellaneous: _ LOW SLOPE AREAS Material Manufacturer. ADDITIONAL AREAS OF CON! All a-tional areas of construction will be repaired or re Gutters ❑ Paint/Stain ❑ Siding ❑ Windows Notes: "Scope of Restoration Services Provided shall include any additional s This Agreement does NOT obligate the Customer nor Company in ar restoration services to be provided by Customer's insurance compan Agreement, including all terms on the reverse side hereof. Custome Customer Payment is due upon completion of each trade. Compan manufacturer's installation instructions & the }l�ocal budding od s Agreed Price: SVt'Gaal L C c R "S shaft b the o az authorized insurance supplements or as set forth on the reverse side Approximate Dates of Service. Substantial commencement of work subject to any permissible delays as per provision (41 on the reverse s By signing this Afire gent you agree that you have also been provide, _tslaftUWn rat rewetyv approval. I accept the above terms of this cor Approved and accepted lCustomerl Approved and Accepted (Customer) SERVICE AGREEMENTS GAF ROOFING SYSTEMS tUCTION,. SCOPE OF RESTORATION SERVICES TO BE PROVIDED ced with high grade materials of tike kind and quality ; SERVICE AGREEMENT ❑ Interior ❑ Skylight ❑ Other 104 STANDARD Material - Manufacture Standard Workmanship Repair 1 yr Full Replacement 2 yrs pp(ements and services approved by Customer's insurance company and accepted by Company. way unless the insurance claim is approved for repairs or replacement to the above mentioned/written scope of and excepted by Company. Customer's signature below signifies acceptance of all terms and conditions of this 's total out of pocket expenses are not to exceed insurance deductible plus upgrades for non -insurance items. and its authorized representatives are NOT acting as public insurance adjusters. Ali work is installed per the oount due to Company under this Agreement, which is subject to any adds ons and/or deductions pursuant to iereof Total estimated cost of any non -insurance upgrades shaft be: $__ a(t mean either the physicald very of me onto the premises or the performanc any t bor aalt be ie Approximate Start Oate: Approximate Completion Date: notice of this right to cancel orally in addition to a writing contained herein This contract is subject to Compa y ract and authorize Company ed. �l .`'S_` t ' Date ppro ed and Acce d (Companyl Date Date I have received the Things to Remember document Ini i s RIGHT OF CANCELLATION PURSUANT TO FEDER L REGULATION AND COL. REV. STAT. 5-3-403: YOU, THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDN GHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. SEE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. RIGHT OF CANCELLATION PURSUANT TO COL. RE V. ST. 4 6-22-104: YOU, THE BUYER, MAY CANCEL THIS AGREEMENT AT ANY TIME WITHIN 72 HOURS AFTER YOU HAVE BEEN NOTI ED THAT YOUR INSURER HAS DENIED YOUR CLAIM TO PAY FOR THE GOODS AND SERVICES TO BE PROVIDED UNDER THIS AGREE ENT. SEE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. Company shall hold in trust any payment from Customer until Co Impany has delivered the materials to your property or has performed a majority of the work on the property. r r r.•r Material - enetrations 50 -year 50 -year STANDARD �� �•. manufacturer warranty 25 -year service policy manufacturer warranty 10 -year service policy go -yew to -year manufadurorworranty manutacturarwamnty Workmanship 5 yrs Workmanship 2 yrs 5 -year service pa0cy 2 -year Other Non -Prorated Non -Prorated workmanship warranty aon Proraizd ire aim Customer In:tiais Transferrable Transferrabte i anste ratite ROOF SYSTEM tUCTION,. SCOPE OF RESTORATION SERVICES TO BE PROVIDED ced with high grade materials of tike kind and quality ; SERVICE AGREEMENT ❑ Interior ❑ Skylight ❑ Other 104 STANDARD Material - Manufacture Standard Workmanship Repair 1 yr Full Replacement 2 yrs pp(ements and services approved by Customer's insurance company and accepted by Company. way unless the insurance claim is approved for repairs or replacement to the above mentioned/written scope of and excepted by Company. Customer's signature below signifies acceptance of all terms and conditions of this 's total out of pocket expenses are not to exceed insurance deductible plus upgrades for non -insurance items. and its authorized representatives are NOT acting as public insurance adjusters. Ali work is installed per the oount due to Company under this Agreement, which is subject to any adds ons and/or deductions pursuant to iereof Total estimated cost of any non -insurance upgrades shaft be: $__ a(t mean either the physicald very of me onto the premises or the performanc any t bor aalt be ie Approximate Start Oate: Approximate Completion Date: notice of this right to cancel orally in addition to a writing contained herein This contract is subject to Compa y ract and authorize Company ed. �l .`'S_` t ' Date ppro ed and Acce d (Companyl Date Date I have received the Things to Remember document Ini i s RIGHT OF CANCELLATION PURSUANT TO FEDER L REGULATION AND COL. REV. STAT. 5-3-403: YOU, THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDN GHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. SEE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. RIGHT OF CANCELLATION PURSUANT TO COL. RE V. ST. 4 6-22-104: YOU, THE BUYER, MAY CANCEL THIS AGREEMENT AT ANY TIME WITHIN 72 HOURS AFTER YOU HAVE BEEN NOTI ED THAT YOUR INSURER HAS DENIED YOUR CLAIM TO PAY FOR THE GOODS AND SERVICES TO BE PROVIDED UNDER THIS AGREE ENT. SEE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. Company shall hold in trust any payment from Customer until Co Impany has delivered the materials to your property or has performed a majority of the work on the property. r r r.•r Material - Material - Manufacture Standard Manufacture Standard Workmanship 5 yrs Workmanship 2 yrs )e Out-of-pocket upgrade costs for Customer In:tiais tUCTION,. SCOPE OF RESTORATION SERVICES TO BE PROVIDED ced with high grade materials of tike kind and quality ; SERVICE AGREEMENT ❑ Interior ❑ Skylight ❑ Other 104 STANDARD Material - Manufacture Standard Workmanship Repair 1 yr Full Replacement 2 yrs pp(ements and services approved by Customer's insurance company and accepted by Company. way unless the insurance claim is approved for repairs or replacement to the above mentioned/written scope of and excepted by Company. Customer's signature below signifies acceptance of all terms and conditions of this 's total out of pocket expenses are not to exceed insurance deductible plus upgrades for non -insurance items. and its authorized representatives are NOT acting as public insurance adjusters. Ali work is installed per the oount due to Company under this Agreement, which is subject to any adds ons and/or deductions pursuant to iereof Total estimated cost of any non -insurance upgrades shaft be: $__ a(t mean either the physicald very of me onto the premises or the performanc any t bor aalt be ie Approximate Start Oate: Approximate Completion Date: notice of this right to cancel orally in addition to a writing contained herein This contract is subject to Compa y ract and authorize Company ed. �l .`'S_` t ' Date ppro ed and Acce d (Companyl Date Date I have received the Things to Remember document Ini i s RIGHT OF CANCELLATION PURSUANT TO FEDER L REGULATION AND COL. REV. STAT. 5-3-403: YOU, THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDN GHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. SEE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. RIGHT OF CANCELLATION PURSUANT TO COL. RE V. ST. 4 6-22-104: YOU, THE BUYER, MAY CANCEL THIS AGREEMENT AT ANY TIME WITHIN 72 HOURS AFTER YOU HAVE BEEN NOTI ED THAT YOUR INSURER HAS DENIED YOUR CLAIM TO PAY FOR THE GOODS AND SERVICES TO BE PROVIDED UNDER THIS AGREE ENT. SEE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. Company shall hold in trust any payment from Customer until Co Impany has delivered the materials to your property or has performed a majority of the work on the property. A 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: f� �_F Job Address: Permit Number: _V (, ❑ No one available for inspection: Time, ��rAM/PM Re -Inspection required: Yes /No When *When corrections have been made, calf for re -inspection at 303 -234 - Date:— 1 ! Inspector: DO NOT REMOVE THIS NOTICE 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: ` ,ur Job Address: ^i!I ( a N Permit Number: 'Z X17„ ( q, , M i Ir �r r ❑ No one available for inspection: Time 6M/PM Re -inspection required: ('Yes No When corrections have been made, call for re -inspection at 303-234-5933 Date: 1 /-7//1 Inspector: / DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax Inspection Type: Job Address: Permit Number: INSPECTION l ,/ q On, ❑ No one available for inspection: Time__ AM Re -Inspection required: Yes �o) When corrections have been made, call for re -inspection at 303-234- t__ Date: `- l%- Inspector: '� A, DO NOT REMOVE THIS NOTICE 30IION SIH13AOW3tf ION 00 ?J�) :ao}oadsul �- 1' b :ale( E£65-tb£Z-£0£ le uo►;oadsui-aa aoj ❑eo ` p w uaaq aney sugi;oaaaoo uaUM.. / i , r ON ta),! :paainbaa uoi}oadsu ja8-� Nd/M. awil :uoi1oadsui aol ajgejiena auo ON n ' !j d :aagwnN I!wJGd t,:ssaippd qor :adA1 uopedsul 331ION N01103dSNI XeJ 6Z68-L0z (000) • aq!-10 998Z-SOz (000) augj uogoadsul MS -Me (EOE) uoisinla mpedsul 6uiplln8 3Jalb 1V3HM =10 A110 �J CITY OF WEAT RIDGE 04/25/12 11:18 AM edba Darcy Tokraks RECEIPT »L 159 ANOUNT KISP Install 9�4 qpm tank 143.89 20120472 PeTmit Fee 93.35 Use 'Tax %54 PAYMENT RECEIVED ANOUNT VS 3376 143.89 Auth Codem 070436 TOTAL 14189 ------------------ ------ MUM= Property Address: *��] mm=ml "i UL ME�� Sub Contmotors: LfrAlMe M. EygiMV2n 12gg; jra§qtEMfM!_qLj* is a (description). L A— MIRIM. ............... All i _ lif wig 0074�77 ZONIN DEPARTMENT USE ONLY G COMMMS: zonlng Reviewer MIH • • FIRE OePARTMENt: 0 approved wl comments 0 disapproved 0 no review required a '"~!.""~"""~".",,,,,,,.. "k""'''.,,''''.''''''"<'''''''''''''''''''''''''''''.'"''.'~'.''''''''''''''~Y'"'~!'0'",,,,,,,,,,,,,,,,,,,,;;I.",.,,,,,,,,,,,,,~<!l'l,~~,.".,~,,,,:,, ./~.~_I\ff()r= PLANNING ANO OEVELOPMENT Building Permit Number: 6189 .p-,Y~.4)_"'PECTJ()NDIVISION . 235.2855 CI'I"V 01= MIlA TRlOGE Date: 11/6/97 .1'500 WEST 29TH AVENUE WfJEA.T RIDGE,C080215 Pro~rty Owner: Property Address: 4115 JAY ST Contractor Licerise No.: 18986 COmpany: Elec::trlcal Remodel Services Phone: 421-2556 Phone: 989 2393 OWNERlCONTfV,CTPR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby cerItfy Ji.atu-.~ __ JlIllPOSed by this pennIlapplicalion are lICC\Irate, ='::,::::~==.nc:r.:=:%.~==n<r.~:~~ mtde are ~ !hat I have ftIIl(I and \0 abide aU condlllona JlIlnled on this app1lcaliQn. Wld.lhat 1_ fUU for Whaat RIdge BuIldIn8 Coda (U_B.C.) ~au olIler applltllbki r under this pennil. (OWNER)(cofmlACTOR) SIGNeD Description : Construction Value : Pennlt Fee : Plan Review Fee: UseTax: $150.00 $25.00 $0.00 $1.80 !+, -$26.80 Total: BUILDING DEPARTMENT USE ONLY SIC: Sq. Fl : Approval: Occupancy : Walls: Roof: Stories: Residential Units : Plumbing License No : Company: Mechank:alLicense No : Company; Electrical License No : Company: Expiration Date : Approval : . Expiration Date : Approval: . Expiration Date : Approval : . (11 1\"-==~!!ic;.;;:~~-:::ro'W"'.=~~ct8lorawsof8lo_0I~an<I"'8loZonlno (2) ~1::=~~t1<ouIhoriZed Is not_wIlhIn sbdy (80) days 110m Issu&_ or (B) the buiIdlnO~ls....-or (3) =..rJ:a'f:"'~'~~~~':::'':''~haI~",===(='\'I=:'~~'=::or''''''~ -._UI_,AdI__blojlold .-- 145) NO W9II< oflll!)> _ HI'" dona UlaI wlII cbanga lha _ _ of _ causing a draInoga plIlbIom- ) ~~~ ~.:'idlng~F 1WonIy-_ (24) hours In _lor a1lli1specllona ond _ __epplOYaI on InspeCIIoncanl_ . 'i1:'.........llf. po.mIt""II:'';:'''', ~s ond opeCItIcatIons sholl not... construed to... . po.mIt for, nor an appnwaI 01, arrt'- of 1110 pmvisionS 8lollCllklll!O Ofarrt__Iaw,lUIaorl8QUlall<>n. ChiefBl/ildlng lilsj)eetor THIS PERMIT VALID ONLY WHEN SIGNED BY THE CHIEF BUILDING INSPECTOR AND MAYOR CALL: 234-6933 24 HOURS PRIOR TO INSPEOTlON DEPARTMENT OF PLANNING AND DEVELOPMENT Building Permit Number: BUILDING INSPECTION DIVISION - 235-2855 CITY OF WHEAT RIDGE Date: 7500 WEST 29TH AVENUE WHEAT RIDGE, CO 80215 - Property Owner: b/+I.:J .J)fy S J P. u.:5 <;~t-- Property Address: 'I I IS Sit'! ST, Phone: '1;<.) - ;;25'7~ Contractor License No.: 2'8';<.;;- Company :fJec-fl7c~/ f(~flII{)j.e[ 5erv, ce <; Phone JI?l9- ;2593 OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT Construction Value: / SO, 00 Permit Fee: Plan Review Fee: Use Tax: 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 a~ree to abide by all conditions printed on this application, and that I assume full responSibility for compliance with the Wheat Ridge Building Code (U.B.C.) and all other applicable Wh t Ridge ordinan s or work under this permit. (OWNER)(CONTRACTOR) SIGNE DATE#:;' Description: t(}1 12t: /.zIJjI1Cf~WT Ful?NfrLE Total: BUILDING DEPARTMENT USE ONLY Z6h~ommentS':l Approval: Zoning: BlilICl1nsrn;.9!!1mentS:] Approvat : p'Dbl~S'~\;.9mlT!e-"~ Approval: Occupancy: Walls: SIC: Sq. Ft.: Roof: Stories: Residential Units : Electrical license No: ;?t:2 .'7' Plumbing License No : Company :Cltdrr<</ f&M.#1l 5eNI'''5 Company: Mechanical License No : Company: Expiration Date: Approval: EIlP.lllIm'~~ Expiration Date : Approval : . feI~R~lml- Expiration Date : Approval: . .~.~~- 'Wi!-' :~~, (4) (5) (6) This permit was lssued In accordance with the provisions set forth In yopur application and Is subject to the laws of the State of Colorado and to the Zoning Regulations and Building Code of Wheat Ridge. Colorado or any other applicable ordinances at the City. This permit shall expire if (A) the work authorued is not commenced within sixty (SO) days from Issue date or (8) the building authorized Is suspended or abandoned for a period of 120 da):'. 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 be made in the original plans and specifications and any suspension or abandonment has not exceeded one (1) year. If Changes are made or if suspension or abandonment exceeds one (1) year, full fees shall be paid for a new permit. No work of any manner shall be done that will change the natural now ot waler causing a drainage problem. Contractor shall notify the Building Inspector twenty-four (24) hours in advance tor all inspections and shall receive written approval on Inspection card before proceediing with successive phases ot the/"Ob. The issuance of a permit or the approval 0 drawings and specifications shall not be construed to be a permit for, nor an approval of, any violalion ot the provisions of the building codes or any other ordinance, law, rule or regulation. (1) (2) (3) Chief Building Inspector For Mayor THIS PERMIT VALID ONLY WHEN SIGNED BY THE CHIEF BUILDING INSPECTOR AND MAYOR CALL: 234-5933 24 HOURS PRIOR TO INSPECTION '"'~~!!, "...."',j~!!Il!,ItHI!,I!",',"""'''''''''''".~''''''"."",J~,.I~,,:UM~l""""'''''''''''''"",,,,'' .,.""",".~..~lIJl",.4'!~ ,1,JtII\.,i." "'~,,~~,~.,'" ,,,,.,_~.~.".,,_,, "", "",.."",J,ll r' DEPARTMENT OF PLANNING AND DEVELOPMENT Building Permit Number: 6216 BUILDING INSPECTION DIVISION. 235.2855 CITY OF WHEAT RIDGE Date: 11/10/97 7500 WEST 29TH AVENUE WHEAT RIDGE, CO 80215 Property Owner: Property Address: 4115 JAY ST Contractor License No.: 19745 Company: Swan Heating & A1C Phone: 421-2556 Phone: 2060264 OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances P.--.e<l by this penn~ application are aocurata, and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record: that 811 measurements shown, and allegations made are accurate: that I have read and agree to ablde b all conditions printed on this application, and that I a..ume full responsible for mpl nce w~h the Wheat Ridge Building Code (U.B.C,) and allathar applicable I 0 ~s, for work under this pennil. (OWNER)(CONTRACTOR) SIGNEd DATE /tIv- Total: $2,330.00 $75,50 $0.00 $27.96 $103.46 Construction Value: Permit Fee: Plan Review Fee: Use Tax : Description: REPLACE FURNACE BUILDING DEPARTMENT USE ONLY SIC: Sq, Fl : Approval: Occupancy: Walls: Roof: Stories: Residential Units : Electrical License No : Company: Plumbing License No : Company: Mechanical License No : Company: Expiration Date: Approval: . Expiration Date: Approval: . Expiration Date : Approval: . (1) This pefmit was issued In accordance with the ~8ions set forth In yopur application and Is subiect to the laws of the State at COlorado and to the ZOning Regulatlons.and Building COde of Wheat ~, Colorado or any other appHcable ordinances of the City. (2) This permtt shall expIra W (A) the work su1horized is not commenced within sixty (60) days from issue date or (B) the building authorized is suspended or abandoned for a period of 120 dsys. (3) W this permtt explras, a naw __ be acqUired for a foe of one-halrtha amount normsHy required, provlded no changes have been or wlII be made In tha original plans and specifications and any suspension or abandonment has not exceeded one (1) year. If changes are made or if suspension or abandonment exceeds one (1) year, ruM fees ahaH be paid for 8 new pennlt. . (4sl No work of any manner shell be done that wi" change the natural flow of water causing a drainage problem. ( Contractor shaD notify the Building Inspector twenty-four (24) hours in advance for all InspectionS and shall receive written approval on inspection card before oroceedllng with successive _ of the job. (6) Ihe Issuance of 8 permit or the approval of dJ'awtngs and spec:lftcations shall not be construed to be a permit for, nor an approval of, any violation of the provisions of the building codes or any other Otdlnance. law, rule or regulation. hief Building Inspector THIS PERMIT VALID ONLY WHEN SIGNED BY THE CHIEF BUILDING INSPECTOR AND MAYOR CALL: 234-5933 24 HOURS PRIOR TO INSPECTION _ DEPARTMENT OF PLANNING AND DEVELOPMENT BUILDING INSPECTION DIVISION - 235-2855 CITY OF WHEAT RIDGE 7500 WEST 29TH AVENUE WHEAT RIDGE, CO 80215 Building Permit Number: Date: Property Owner: Il_{~1h I:"'/f<- /1 Property Address: 1/11{'- >7 a Contractor License No. : Company: c-, " ...::>(.N'O"" A,.1. '-7 I- Ale.. Phone: &oY)<7'c/-o;(., Phone: c?70) JXJ?-020' OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT Construction Value:..:?'3 ~ _ Permit Fee: Plan Review Fee: Use Tax: c. I hereby certify that the setback distances proposed by this pennit 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 (or compliance with the Wheat Ridge Building Code (U.B.C.) and all other applicable Wheat L n for work under this. penmit (OWNER)(CONTRACTOR) SIGNED a . - DATJ-/b-C;:) Total: Description: "C~ +:v< {/lo.c-e_ BUILDING DEPARTMENT USE ONLY Zi5fjlng~ornrn8ntS:l Approval: Zoning: Blillalng.\,;ornrnentS!l Approval: p'Obl~st"'ornll!eJ1~ Approval: Occupancy: Walls: SIC: Sq. Ft.: Roof: Stories: Residential Units: Electrical License No : Company: Plurnbing License No : Company: Mechanical License No : Company: Expiration Date : Approval: EI .. !>S:1(' _.1, _ Expiration Date: Approval: . Ielmr.RllIUlmI Expiration Date: Approval: . 1-. ~i~.' .~;, (1) (2) (3) This permit was lssued In accordance with the provisions set forth in yapor application and Is subject to the laws of the State of Colorado and to the Zoning R~ulations and Building Code of Wheal Ridge. Colorado or any other applicable ordinances of the City. This permit shall expire if (A) the work authonzed Is not commenced within sixty (50) days from issue date or (8) the building authorized Is suspended or abandoned for. period of 120 days. If this permit expires. a new pemut may be acquired for a fee of one-half the amount normally required. provided no changes have been or will be made in the original plans and spedtleetions and any suspension or abandonment has not 8l1:ceeded one (1) year. If changes are made or if suspension Of abandonment exceeds one (1) year, full fees shall be paid for a new permit. No work. of any manner shall be done that will chanoe the nalural now of water causing a drainage problem. Contnlctor shall notify the Building Inspector twenty.four (24) hours in advance for all inspections and shall receive written approval on inspection card before proceediing with successive phases ot the/'ob. 'rhe Issuance of a permit or the approval 0 drawings and specifications shall not be construed 10 be a permit for, nor an approval of, any violation of the provisions of the building codes or any other ordinance, law, rule or regulation. !~l (61 Chief Building Inspector For Mayor THIS PERMIT VALID ONLY WHEN SIGNED BYTHE CHIEF BUILDING INSPECTOR AND MAYOR CALL: 234-5933 24 HOURS PRIOR TO INSPECTION DEPARTMENT OF PLANNING AND DEVELOPMENT Building Permit Number: 95- 830 BUILDING INSPECTION DIVISION - 235-2855 CITY OF WHEAT RIDGE Date :4/27/95 7500 WEST 29TH AVENUE WHEAT RIDGE, CO 80215 Property Owner: RUSSELL PAULETTE E Property Address: 4115 JAY ST Phone: 421-2556 Contractor License No. : 17946 Company: Charles Lujan Roofing Phone: 2398910 OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT Construction Value: Permit Fee: Use Tax: 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 a~ree to abide by all conditions printed on this application, and that I assume full responsibility for compliance with the Wheat Ridge Building Code (U.B.C.) and all other applicable Wheat Ridge ordinances, for work under this permit. Total: $2,100.00 $54.00 $31.50 $85.50 (OWNER)(CONTRACTOR) SIGNED DATE Description: REROOF BUILDING DEPARTMENT USE ONLY Approval: Zoning: Approval: Approval: Occupancy: Walls: Roof: Stories: Residential Units: Electrical License No : Company: Plumbing License No : Company: Mechanical License No : Company: Expiration Date: Approval: .. Expiration Date: Approval: III Expiration Date: Approval: III This permit was issued in accordance with the provisions set forth in yopur application and is subject to the laws of the State of Colorado and to the Zoning Regulations and Buildin9. Code of Wheat Ridge, Colorado or any other applicable ordinances of the City. This permit shall expire If (A) the work authorized is not commenced within sixty (60) days from issue date or (B) the building authorized is suspended or abandoned for a period of 120 days. If this permit expires, a new permit may be acquired for a fee of om~...half the amount normally required, provided no changes have been or will be made in the original plans and specifications and any suspension or abandonment has not exceeded one (1) year. If changes are made or if suspension or abandonment exceeds one (1) year, full fees shall be paid for a new permit. No work of any manner shall be done that will change the natural flow of water causing a drainage problem. Contractor shall notify the Building Inspector twenty.four (24) hours in advance for all inspections and shall receive written approval on inspection card before proceediing with successive phases of the/.ob. The issuance of a permit or the approval 0 drawings and specifications shall not be construed to be a permit for, nor an approval of, any violation of the provisions ofJhe building codes or any other ordinance, law, rule or regulation. , S /' '/ ( i- CC) C<j'/0-.__. '{ C:v/ " , hief Building Inspector THIS PERMIT VALID ONLY WHEN SIGNED BY THE CHIEF BUILDING INSPECTOR CALL: 234-5933 24 HOURS PRIOR TO INSPECTION (1) (2) (3) (4) (5) (6) [S~1Z] Q~ DEPARTMENT OF PLANNING AND DEVELOPMENT Building Permit Number: BUILDING INSPECTION DIVISION - 235-2855 CITY OF WHEAT RIDGE Date: 7500 WEST 29TH AVENUE WHEAT RIDGE, CO 80215 aI/I.,. II -e. [)I/c!/K/n.. L;//t}Tul Sf Contractor License No.: J 7 '1 'if;; CompanycA 0//v5 L~'u.-, R,:?//H/ Cc- Property Owner: Property Address: Phone: Lj;; / - ;2S-r~ Phone: ? J ?-F7/cJ OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT Construction Value: Use Tax: ,?-/oo.oo S c.{ 0-eJ ~ {, \0 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 responsi .~. r com lianee with t Wheat Ridge Building Code (U.B.C.) and all other applicable W . ge 0 na S, to ark under this permit. (OWNER)(CONTRACTOR) SIGNED ~,' DATEIj~;; )-'7J - Description: ?ftJoF vi r!-C///'f'fJ tJlf/ 1ft7t/JY' (7'/I! BUILDING DEPARTMENT USE ONLY Permit Fee: "", 1'-" .-> G".~J Total: Approval: Zoning: Approval: Approval: Occupancy: Walls: Roof: Stories: Residential Units: Electrical license No : Company: Plumbing license No : Company: Mechanical license No : Company: Expiration Date: Approval: II ...."RlIB-ill Expiration Date: Approval: 1lII, llii.bs.R_lj.....'L6l'~ e; ,,' _"~,";;'1h Expiration Date: Approval : ,. (1) (2) (3) This permit was issued in accordance with the provisions set forth in yopur application and is subject to the laws of the State of Colorado and to the Zoning Regulations and Building Gode of Wheat Ridge, Colorado or any other 81lplicable ordinances of the City. This permit shall expire If (A) the work authorized IS not commenced withm sixty (60) days from issue date or (8) the building authorized is suspended or abandoned for a ,period of 120 days. 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 be made in the original plans and specifications and any suspension or abandonment has not exceeded one (1) year. If changes are made or if suspension or abandonment exceeds one (1) year, full fees shall be paid for a new permit. NO work of any manner shall be done that will change the natural flow of water causing a drainage problem. Contractor shall notify the Building Inspector twenty-four (24) hours in advance for all inspections and shall receive written approval on inspection card before proceediing with successive phases of the job. The issuance of a permit or the approval of drawings and specifications shall not be construed to be a permit for. nor an approval of. any violation of the proviSions of the bUilding codes or any other ordmance. law. rule or regulation. (4) (5) (6) Chief Building Inspector For Mayor THIS PERMIT VALID ONLY WHEN SIGNED BYTHE CHIEF BUILDING INSPECTOR AND MAYOR CALL: 234-5933 24 HOURS PRIOR TO INSPECTION