HomeMy WebLinkAbout4140 Ingalls Courtif of
W he at cye
COMMUNYTY DEVELOPMENT
2" "A'.. 4. X' .R' R 4-A. k-M:O "i'Mi A
Date.
1-7
ftn Review Fft:
Building Permit Application
-J
Address: t -A ('44 10-Cfi-
City, State, Zip: 03,��
Electrical:
WR Cjb� Ucense #
Plumbing,
---------- - -----
Complete all infonnation on BOTH sides of this form
NEW COMMERCIAL STRUCTURE ELECTRICAL SERVICE UPGRADE
NEW RESIDENTIAL STRUCTURE COMMERCIAL ROOFING
COMMERCIAL ADDITION RESIDENTIAL ROOFING
RESDENTIAL ADDITION WINDOW REPLACEMENT
COMMERCIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.)
RESIDENTIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.)
MECHANICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT
PLUMBING SYSTEM/APPLIANCE REPAIR or REPLACMENT
ELECTRICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT
OTHER (Describe)
x
Sc� FULF Stu's Galion$
Amps Squares '94 ottler
f � I
MMSEM"1
Mailing ddress if different than property address)
Address:
City, State, Zip;
Complete all information can BOTH sides of this form
Sq. Ft /LF Stu's Gallons
Amps 1 Squares Other
OWNER/CONTRACTOR SIGNATURE GIB 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 Albeat 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.
Buildin Division Valuation* $
DEPARTMENT OF PLANNING AND DEVeLOPMENT
BUILDING INSPECnON DMS'ON . 235.2855
CITY OF WHEAT RIDGE
7500 WEST 29TH A VENUE
WHEAT RIDGE, CO 80215
Building Pennit Number:
Date:
Property Owner: I?, ,1"/",, If., I,c';t:;,/
Property Address: 'i / if 0 'y--1"7 /,/' /5 L Z..
Contractor License No.: / 7/ r2..
Company: fJr~c./.s~ //...", t'/,.? ..z;, c-
Phone.: 1(,;;/- C) /0.2. ,
/3.3)
Phone: 5""JP'-~ r..../
-
r OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
Construction Value:
Permit Fee: ;ti 'SO
Use Tax: ~"'''.s Pf:J-OWf'}
I hereoy certify Ihaltlle .elDeClc dislllnces _ II\' tIlis P8111l1l__lion are aCClll8t8.
and do not YIO"ue applicable _nces. IUIaa or ~ of IIIe CiIy of WIle. Ridge 01
__1Ila. ea_1Ila or reab'C:lio"a of -=lIIal.. ....__ _. ana r""""r IS
,.- are accume: lIIall "... ""..s::'.~1 by .. CCIl 14'1 IS""" on 1tIls. .
appItCalion. ana lIIal/uaume fill far CDI1I~b"lCa _.... WMM RIdge 8uId/ng ,
CNe(U.8.C.)anaa/l_a~~': !',WMM _far___penn&
(OWNER)(CONTRACTOR) ~IGNED~' .~ ./'~ DATE ' .
Description: r~/hc~ u10 -t:,r II.....~,.. ./ r-f'I&e1- ,cor I'''' ~.." rt:'o'"
ToIaI:2iS"D,
BUILDING DEPARTMENT USE ONLY
~"lIJJ'''i:l.!J--,.1~
Approval :
Zoning:
~ ~~!J-"II'-"'"",:-rl 0:':J:",1-
Approval:
.~"-:"~~ud.m1a:!
Approval:
Occupancy:
Walls:
Roof:
Stories:
Residential Units :
Electncal License No :
Company:
PlumbIng License No :
Company: .
Mechanical License No :
Company :
Expiration Date:
Approval:
.3 (PJliJSR.-qulriCl~
Expiration Date:
Approval:
iI :. PIIba ~ulred';~ .J
") nUs P&11M wallSSUed In aCClOldllnce wm Ihe ~ let fonn 1ft YODUI' aQI:IICaDOn .no II suotecllCllhlllawa of the Sl8Ie 01 COknao ana Ia III' Zoning'
Re;uaauons ana 8uddrn9 Cod, of Wheal Redoe, Co:oraao or Iny 0Iner ID.-ea* Ol'OtnanCll of Iftl City.
(2) This penm snao uew. If fAllne wont lutnonZea IS flO1 c::omrnenc:ea Wlwn IIl1Y (00) dIIYI Irom uue dlle or (8) the buiklUIO.UIftOnZea IIIU1PMCMC1 Of
attanaoneo tor a DenOO Of , 20 daya.
(3) 11 hs permn IXDUeI. . new ..... may De KQuncI rot a ,.. 01 0M-IWt... amount nonnaIy reouncf. PRMdIG no c:ftMgeI nave..., or wit be tnIGIt II lie
ongtnaI pI.ns anG sD8Cl6caDOftl and any SUIMftIIOn or 1000Mlol",*,1 ftU net. CJ J.~ one (1),... "cr..,.....,..,. Of illUIPIftIIatI Of aDllMIOI~~\)",.1(
UCNaI one 11) year. tutI ,....,..... EMIlI far I,... oemwt.
(41 No wen: 01 any manner Iftl. De clOne Nt WII Cftange 1M ".tural!low of w... c:eusenq I draln898 protIIIm.
~S) Connaar snail nobly the 8u*""9 InlDeClOl' twemyolQur (24) hOurs an adV.nce tor... InlpecDOftS ana lIIII,ecwve wnaen IPPI'OWI on "'11IICDOl'I CM:I DreIDre
ptOC:IHGang "'ttn succeSSIVe Dna'" oIlhe 100.
:e) The ISsuance Ofl Dermrr or tne apDfOY8I 01 Grawtnqs ,no soeaJ\clbOns snail not De CDns~ 10 oe I permn for, nor an Ipproval of. Iny YIOtaDOn of... PftMIIOna
0' Ine DU1IOln9 coaes or .In,;, orn.r orl1lnance. law. t\I;e or regULIllOfl.
Chief Building Inspector." ,.,.". For Mayor
. THIS PERMIT VALID ONLY WHEN SIGNED BY THE CHIEF BUILDING INSPECTOR ANi:fMA YOR '
CALL: 234-5933 24 HOURS PRIOR TO INSPECnON