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HomeMy WebLinkAbout3720 Independence Streeti_ CITY OF WHEAT RIDGE _:�9�Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type:F Job Addreps: a OPermitNumber: 00t-6 1 c� (\ (D n L) ❑ No one available for inspe tion: Time)Qt5C AlVl M) Re -Inspection required: Yes Nd When corrections have been made, call for re -inspection at 303-234-5933 Date: (,I, Inspecto 1 DO NOT REMOVE THIS NOTICE 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: -Sa 1, �_ H L Job Address: 7 c 1 Permit Number: v �) `� a Ey Icr r , , u nveT Nc /< ✓� �t ❑ No one available for inspection: Time b . RANI/PM Re -Inspection required: Yes No When corrections have been made, call for re -inspection at 303-234-5933 Date: `41 1 Z) ► 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: F L T Job Address: 3 ML N d S4 Permit Number: LlNo one available for inspection: Time &/PM Re -Inspection required: Yes N� When corrections have been made, call for re -inspection at 303-234- Date:- q I I Z.I Inspector:, "� DO NOT REMOVE THIS NOTICE o i CITY OF WHEAT RIDGE Building Inspection Division �(303) (303) 234-5933 Inspection line 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE P Inspection Type: ls1:i7_ Job Address: Permit Number: ) a ❑ No one available for inspection: Time AM/PM Re -Inspection required: Yes No When corrections have been made, call for re -inspection at 303-234-5933 Date:L4-114 f / 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: u v Job Address: �~1 ac IJ e�nr Permit Number: ❑ No one available for inspection: Time AM/PM Re -Inspection required: Yes No When corrections have been made, call for re -inspection at 303 -234 - Date: �i lo� Inspectors DO NOT REMOVE THIS NOTICE City of Wheat Ridge r Residential Mechanic PERMIT - 201800927 PERMIT NO: 201800927 ISSUED: 04/04/2018 JOB ADDRESS: 3720 Independence ST EXPIRES: 04/04/2019 JOB DESCRIPTION: Install a new 1/5 ton A/C. Electric work will include a new 220V circuit with GFI outlet. *** CONTACTS *** OWNER (303)359-2793 LORICK BOBBIE SUB William Buras 017865 Lakeside Heating & A/C *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 5,000.00 FEES Total Valuation 0.00 Use Tax 105.00 Permit Fee 125.05 ** TOTAL ** 230.05 *** COMMENTS *** *** CONDITIONS *** Work shall comply with 2012 IRC & 2014 NEC. Per IRC Sec. R314, smoke detectors are required to be installed in every sleeping room, in hallways outside of sleeping rooms, and on every level of the structure. I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications applicable buildingcodesanall 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 ermit. I further attest that I am legally authorized to include al I entities named within th%s document as parties to the work to be performed and that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications. Signature ofd OWNER or CONTRACTOR (Circle one) Date 1. This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and 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 an 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 n t roceed or conceal work without written approval of such work from the Building and Inspection Services Divis 6. The ' nce r grant' f a ermit shall not be construed to be a permit for, or an approval of, an violation of any provision of any app r a 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 Wheat cq1 COMMtJNay DEVELOPMENT Building & Inspection Services Division 7500 W. 29`h Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: permits ,ci.wheatridge.co.us FOR OFFICE USE ONLY Date: qlql Plan/Permit # 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: J7,2®-7g,-%Ptoo1egC.&_. 5t - Property Owner (please print): Arbbi'e. Ler,'c:.I{ Phone: 3r', -.35% 713 Property Owner Email: Mailing Address: (if different than property address) Address: City, State, Zip: r 0 Architect/Engineer: Architect/Engineer E-mail: Contractor: LXe,.�:4. Ilea 4%ia /- 4In, J,ie Phone: Contractors City License #: U f '79/0 5 Phone: 3©3 �/_� / - 3,5- 7 -,)- Contractor Contractor E-mail Address: &e_CA< a 1a{e_S,'dx_ h.m Ryi4q • GO M Sub Contractors: Electrical: i)0e,(-)f 1 l elec,7,�e-vc_ W.R. City License # / 95185 Other City Licensed Sub: City License # Plumbing: W.R. City License # Other City Licensed Sub: City License # Mechanical: W.R. City License # Complete all information on BOTH sides of this form ❑ COMMERCIAL ,RESIDENTIAL Description of work: (Check all that apply) ❑ NEW COMMERCIAL STRUCTURE ❑ ELECTRICAL SERVICE UPGRADE ❑ NEW RESIDENTIAL STRUCTURE ❑ COMMERCIAL ROOFING ❑ COMMERCIAL ADDITION ❑ RESIDENTIAL ROOFING ❑ RESDENTIAL ADDITION ❑ WINDOW REPLACEMENT ❑ COMMERCIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.) n RESIDENTIAL ACCESSORY STRUCTURE (Gar--- -hors neck, etc.) I MECHANICAL SYSTEM/APPLIANCE REPAIR ol_.._. ❑ PLUMBING SYSTEM/APPLIANCE REPAIR or REPLACMENT ❑ ELECTRICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT 'v 9 OTHER (Describe) ztiv' AC_ (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.) �/e (., J l).r.w Xz o I/ G, r-c,u_,' t- w ) &F:- Ott-Y-4,E.T T. Sq. Ft.ILF Amps Btu's Squares Gallons Other 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) Electronic Signature (first and last name):�U� t f �t LJ L( r'c`c S DATE: - J } DEPARTMENT USE ONLY ZONING COMMMENTS: OCCUPANCY CLASSIFICATION: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: Building Division Valuation: $ CITY OF WHEAT J/Buildin RIDGE (303 9 Inspection Division (303 234"5933 Inspection 235-2855 Office • INS (,303) 237-8929 Fax Ype: PECTIO / V Inspection T N NOTICE Job Address: Permit Number: O ❑ No one available for inspectio Re -inspection n� Time �- on required: Yes AM/PM When corrections have been made ca// fo re -ins 303-2- Cate: , � pection at Inspector: DO NOT REMOVE NOT/CE INSPECTION RECORD INSPECTION ONLINE FORM: http://www.ci.wheatridge.co.us/inspection INSPECTION REQUEST LINE: (303) 234-5933 Occupanc /y Ttiue tZ9 P 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 - 1�1I Concrete Encased Ground (CEG) Foundation / P.E. Letter Do Not Pour Concrete Prior To Approval Of The Above lini-s'peotions Underground/Slab Inspections Date Inspector Initials Comments Electrical Comments Sewer Service 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. Plumbing Do Not Cover Underground or Below/In-Slab Work Prior To Approval Of The Above Inspections Rough Inspections Date Inspector Initials Comments 44bitl Sheathing oda 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. Mid -Roof i Fire Inspection / Fire Protection Dist. Lath / Wall Tie Final Plumbing Rough Electric " Final Mechanical Rough Plumbing/Gas Line Roof Z. - Rough Mechanical Final Building Rough Framing 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. Rough Grading Insulation 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 Z. - Final 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 City of Wheat Ridge Residential Roofing PERMIT - 201704162 PERMIT NO: 201704162 ISSUED: 07/17/2017 JOB ADDRESS: 3720 Independence ST EXPIRES: 07/17/2018 JOB DESCRIPTION: Residential Re -roof to install dimensional laminated asphalt shingles - 21 sq ***REVISION ADD REDECKING $1100 *** CONTACTS *** OWNER (303)948-0337 VANBLARCOM BOBBI L SUB (303)948-0337 Mike Bye/Bill Szymanski 150175 ProWorx Exteriors *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 7,400.00 FEES Total Valuation 0.00 Use Tax 155.40 Permit Fee 172.60 ** TOTAL ** 328.00 *** 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. e City of Wheat Ridge r Residential Roofing PERMIT - 201704162 _1�9� PERMIT NO: 201704162 ISSUED: 07/17/2017 JOB ADDRESS: 3720 Independence ST EXPIRES: 07/17/2018 JOB DESCRIPTION: Residential Re -roof to install dimensional laminated asphalt shingles - 21 sq *** CONTACTS *** OWNER (303)948-0337 VANBLARCOM BOBBI L SUB (303)948-0337 Mike Bye/Bill Szymanski 150175 ProWorx Exteriors *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 6,300.00 FEES Total Valuation 0.00 Use Tax 132.30 Permit Fee 156.75 ** TOTAL ** 289.05 J *** 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. ® City of Wheat Ridge E Residential Roofing PERMIT - 201704162 PERMIT NO: 201704162 ISSUED: 07/17/2017 JOB ADDRESS: 3720 Independence ST EXPIRES: 07/17/2018 JOB DESCRIPTION: Residential Re -roof to install dimensional laminated asphalt shingles - 21 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 apg,icble municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the properly anauthorzed toobtainthishisermit. I furtherattestthatIamlyauthorizd toinclude alperormed and that allwork tobe peed is disclosed in this document and/or its' accompanying approved plans and specifications. Signature of OWNER or CONTRACTOR (Circle one) Date 1. This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and 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 issuance or granting of a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any applicable code o ordinance or re u ation oft 's 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. Dane Lovett 70i7oM2- From: no-reply@ci.wheatridge.co.us Sent: Friday, July 7, 2017 2:01 PM To: Permits CommDev 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 3720 Independence Street Bobbi Van Blarcom 303-948-0337 Field not completed. L-1/1 C L" Gq1 L 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 ProW orx Exteriors 150175 303-948-0337 Contractor Email Address info@proworxco.com Retype Contractor Email Address DESCRIPTION OF WORK Are you re -decking the roof? Description of Roofing Material Select Type of Material: If "Other" is selected above, describe here: How many squares of the material selected above? Does any portion of the property include a flat roof? If yes, how many squares on the flat roof? info@proworxco.com No Asphalt Dimensional -Laminated Asphalt, Rolled Field not completed. 21 No Field not completed TOTAL SQUARES of all 21 roofing material for this proj ect Provide additional detail R&R Lamintaed shingle for house and detached garage. 2/12 here on the description of and 4/12 0) work. (Is this for a house or garage? What is the roof pitch? Etc) 0,3006 Project Value (contract value or cost of ALL materials and labor) 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 Bill Szymanski Email not displaying correctly? View it in your browser. 3 Q '4 eM,...:' eN ' .1110 • i •�: 1 2 • • • •Ii -• • • • • Proposal Submitted To: I '\`A I c. P—c ry1 Date: �° _ ' Repair /Replace Gutters Prow— Rep: t '5 2 'f F Street Address: —7ZVn� .- �" ,.' P . 1 Home •: s Insurance Co: n7r/4r City, State Zip Code: ' Z. i (!o office if. Agents Name: -i A —T-IZ `J E-mail, M: tz-! claim C. J When the Insurance Co. and ProWorx come to an agreement on price, that price will be the final contract amount. ProWorx will receive all insurance proceeds for the work completed. ProWorx shall holo in trust any paym received from the customer until roofing materials have been delivered to your property. ( Customer initial } (ProWorx Rep. initial) _ Remove �[_ Layers �� Underla ment Material ` ` __ � r � R' • . Roo Pitch: "-- Brand of Shingle 0 � Drip Edge Type " � r �� { ` ' Valley Underlayment L Style of Shingle( Drip Edge Color - r m Ice/Water Shield Color of Shingle Nails: 1-1/4"' 1-1/2"_ 1-3/4"_ Clean Up &Haul Off Trash Product Warranty �-76-7 V, Replace Pipe Jacks: ProWorx to furnish Permit Ridge Material Type,; 3V rF Step Flashing Venting / Qty. Type'Qt2 t CCounter Flashing, E<- boeclal Instruction i Attention to uetans: Q t -C, C.c;� c:) F�t k. T'Z> 5cc,?L Included OTHER CHARGES F7f�F' L=am `f f� L+.7V k r v Z DESCRIPTION AMOUNT Replace Damaged Decking /sq.ft. Repair /Replace Gutters Repair Leaks / Where? We propose to furnish material & labor to complete work in accordance with specifications above, for the sum of: 1st Installment d installmen Supplement: Deductible: Total Amoun , / """ ate,,,-,�• E.,�.. - Approximate dates of service: r ✓ ;� pe►2M• k ? CUSTOMER HAS THE RIGHT TO RESCIND THIS CONTRACT & OBTAIN A FULL REFUND OF ANY DEPOSIT WITHIN 72 HOURS AFTER ENTERING THE CONTRACT. IF CUSTOMER PLANS TO USE PROCEEDS OF A PROPERTY & CASUALTY INSURANCE POLICY TO PAY FOR THE ROOFING WORK, YOU MAY RESCIND THIS CONTRACT WITHIN 72 HOURS AFTER YOU RECEIVE WRITTEN NOTICE FROM THE INSURER THAT YOUR CLAIM HAS BEEN DENIED. HOWEVER, PROWORX IS ENTITLED TO RETAIN PAYMENTS OR DEPOSITS TO COMPENSATE PROWORX FOR WORK ACTUALLY PERFORMED IN A WORKMANLIKE MANNER CONSISTENT WITH STANDARD ROOFING INDUSTRY PRACTICES. COLORADO SENATE BILL 38 COMPLIANCE: PROWORX CANNOT PAY, WAIVE, REBATE OR PROMISE TO PAY, WAIVE OR REBATE ALL OR PART OF ANY INSURANCE DEDUCTIBLE APPLICABLE TO THE INSURANCE CLAIM FOR PAYMENT FOR ROOFING WORK ON YOUR PROPERTY. ACCEPTED BY:DATE: 7 By signing above, the homeowner authorizes ProWorx to pursue an agreeable replacement/repair price with the ins ranc company, alongside the homeowner's best interests. This proposal does not obligate the homeowner unless approved by the insurance company & ProWorx. The customer's out of pocket expense will not exceed the deductible amount plus any added upgrades and/or additional requested work by the customer. This agreement consists of terms yd conditions on the front and backside of this document. PROWORX REP:_ G DATE: (�, "dS' 1-7 City of Wh6atp-,dge COMMUNITY DEVELOPMENT 7500 W. 2911 Avenue * Wheat Ridge, CO 80033 * O: (303)235-2855 * F: (303)235-2857 Contractor Waiver for Workers' Compensation Insurance I, (print your name), verify that I am the sole owner or partner of (company name): which has n6 employees and is not required by the State of Colorado to carry workers' compensation insurance. I further state that if I hire subcontractors, they are in compliance with the State of Colorado Workers' Compensation insurance requirements and have obtained the required contractor's business license from the City of Wheat Ridge. Signature: Date: e ► A City of Wheat Ridge _ o Residential Roofing PERMIT - 201704162 PERMIT NO: 201704162 ISSUED: 07/17/2017 JOB ADDRESS: 3720 Independence ST EXPIRES: 07/17/2018 JOB DESCRIPTION: Residential Re -roof to install dimensional laminated asphalt shingles - 21 sq ***REVISION ADD REDECKING $1100 *** CONTACTS *** OWNER (303)948-0337 VANBLARCOM BOBBI L SUB (303)948-0337 Mike Bye/Bill Szymanski 150175 ProWorx Exteriors *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 7,400.00 FEES Total Valuation 0.00 Use Tax 155.40 ID Permit Fee 172.60 I- ** TOTAL ** 328.00 L *** 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. City of Wheat Ridge Residential Roofing PERMIT - 201704162 PERMIT NO: 201704162 ISSUED: 07/17/2017 JOB ADDRESS: 3720 Independence ST EXPIRES: 07/17/2018 JOB DESCRIPTION: Residential Re -roof to install dimensional laminated asphalt shingles - 21 sq 'REVISION ADD REDECKING $1100 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 thisermit. I further attest that I am legally an ized to include all entities named within this document as parties to the work to be performed and that all work ertor disclosed in this document and/o>/ts' accompanying approved plans and specifications. Signature of OWNER or CONTIZACTOR (Circle one) Date " I . This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the originalpermit fee. 3. Ifthis 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 change of the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any applicable code or. any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. WhCity of, eat -Midge COMMUNITY DEVELOPMENT Building & Inspection Services Division 7500 W. 29th Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: Dermits(cDci.wheatridae.co.us I FOR OFFICE USE ONLY I Date: Add to P it # Building Permit Revision/Amendment Application In �Z' 3 8 95 *** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. *** ? 9 Property Address: J 2� C�z��nd f?'► C L� �'� �- Property Owner (please print): 4j , V f",_tJ rp(/q_ Cc,A Phone: Property Owner Email: Mailing Address: (if different than property address) Address: City, State, Zip: � c Contact Person: h' Phone: Contractor: SAr -{ Contractors City License #: Contractor E-mail Address: Phone: Please Note: Additional valuation must include all general and subcontracted work to be performed related to the revisions and/or amendments declared in the description of work and which were not included in the original permit valuation. If revisions or amendments increase the original valuation, additional fees will be due at the time of approval. Depending on the scope of work, additional plan review fees may be due upon approval ($60.00 an hour - 2 hour minimum). Description of revised/amended work: (Z;-6 � i_�J` 05 Sq. Ft./LF Amps Btu's Squares Gallons Other Additional Project Value: (Must include all general and subcontracted work to be performed related to revisions/amendments described above) $ I ODI _J �) 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 I have read and agree to abide by all conditions printed on this application and that 1 assume full responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner or have been authorized by the legal owner of the property to perform the described work and ain also authorized by the legal owner of any entity included on this application to list that entity on this application. CIRCLE ONE. (OWNER) (CONTRACTOR) or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) PRINT NAME: ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: PUBLIC WORKS COMMENTS: Reviewer: SIGNATURE: PROOF OF SUBMISSION FORMS Fire Department ❑ Received ❑ Not Required Water District ❑ Received ❑ Not Required Sanitation District ❑ Received ❑ Not Required DEPARTMENT USE ONLY DATE: OCCUPANCY CLASSIFICATION: Building Division Valuation: $ CITY OF WHEAT J/Buildin RIDGE (303 9 Inspection Division (303 234"5933 Inspection 235-2855 Office • INS (,303) 237-8929 Fax Ype: PECTIO / V Inspection T N NOTICE Job Address: Permit Number: O ❑ No one available for inspectio Re -inspection n� Time �- on required: Yes AM/PM When corrections have been made ca// fo re -ins 303-2- Cate: , � pection at Inspector: DO NOT REMOVE NOT/CE I i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Job Address: 0 dS(-- Permit Number: - Cl 70y/ ❑ No one available for inspection: Time A�M Re -Inspection required: Yes Nom When correction/Inspector: corrections have been made, call for re -inspection at 303-234- Date: -'7, �W �r,;Alc�l& DO NOT REMOVE THIS NOT/CE t ZZMEM Contractor 070156 s ne: 303-360-0126 s e ►r r t1 Credit Card Payment U se credit card listed on file. Date. I ._.. .. Print name ...... ­_­__­­----II-­ --- --- ­I .._..__.__ Signature; . ca Cb La 0 x C> 0 C� m lle III w o n CIN ?o C� 10 to tes O iA lita m C6 sa rr 0, Vi o to e-r F tv to :5 > ;r ac Lisa -, City of Wheat Ridge Residential Electric PERMIT - 060844 PERMIT NO: JOB ADDRESS, DESCRIPTION: 060844 3720 INDEPENDENCE ST T/O old; install new 30YR ISSUED: EXPIRES: laminate shingles. 09/11/2006 03/11/2008 ASTM 3161 *** CONTACTS *** owner 303/422-0934 gc 303/761-6400 George Vinnola J. Bretz 01-8118 Excel Roofing, Inc. ** PARCEL INFO ** ZONE CODE: UA SUBDIVISION: UA USE: BLOCI</LOT#: R-3 0/ ** FEE SUMMARY ** ESTIMATED PROJECt VALUATION: FEES 126.50 .00 58.32 184_82 Permit Fee Total Valuation Use Tax ** TOTAL ** Comments: 7' ':;:0:1: from the manufar;tu7€;' "haii bc c:;;osite for final roof inspection which specify roofing materials have been i"stalled to meet 110 MPH three-second windgu!ft---1BC 3,2 0_00 I hereby certify that the setback distances proposed by this permit application are accurate, and do n t violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, e~sements or restrictions of record; that all measurements shown, an legations made are accurate; that I have read and'agree to abide by all cond tions printed on this applicati d that ass me full responsibility for compliance with the Wheat Ridge Building Code (I B.C) and all other applicab e Whe Ord nances, for work under this permit. Plans subject to field inspection. 1. This permit was issued in accordance with the provisions set forth ~n your application and is subje t to the laws of the State of Colorado and to the Zoning Regulations and Building Codes of Wh~at Ridge, Colorado or any ther applicable ordinances of the City. 2. This permit shall expire if (A) the work authorized is not commenced within sixty (60) days from is ue date or (B) the building authorized is suspended or abandoned for a period of 180 days. 3. If this permit expires, a new permit may be acquired for a fee of one-half the amount normally requ' changes have been or will be made in the original plans and specifications and any suspension or ab exceeded one (1) year. If changes have been or if suspension or abandonment exceeds one (1) year, 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 Contractor shall notify the Building Inspector twenty-four (24) hours irt advance for all inspectio written approval on inspection card before proceeding with successive phases of the job. 6. The issuance of a permit or the approval of drawings and specifications shall not be construed to a permit for, nor an app~o va any v', . f the provisions of the building codes Oll any other ordinance, law, rule or regulation. All p~ 'ew' subJect to fi d inspections. ,,/''''' ..' ;: ,. Signature of Chief BUllding Offical Signature of contractor/owner date 4. 5. date red, provided no ndonment has not ull fees shall oblem, and shall receive INSPECTION REQUEST LINE: (303)234-5933 BUILDING OFFICE: (303)235-2855 REQUESTS MUST BE MADE BY 3PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOW IN BUSINESS DAY. Building Permit Application City of Wheat Ridge Building Permit Application iDepartment of Planning and Development 'Building Inspection Line: 303.234.5933 City of Wheat Ridge 7500 West 29th Avenue ,Wheat Ridge, CO 80215 303.235.2855 'Property O~;;~r: . r:;c.o~~c:.::\Tl;'" ":;oY~' ........... . Property Address: 3"f 2:0 I"'d<-f"-Jo'~<.J""- "-- ST. w~,,-""..-.J.,,,,c. iContractor License No: 21.\,1.. Ro"'~,," c\l rouQ.~.:;r...<;t"-\\.foJ~"'" '30 'fc>Y (Company: ~ \ !-.v.. "".....LS l...; \...S /'o^..<-e'.- jl..)\M-311.1 rOwNER/cONTRAcTORSICNATuRE'OF VN STANDING AND AGREEMENT ,- iI 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 Rid!;e 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 Ion this applications and that I assume full responsibility for compliance with the Wheat ,Ridge Building Code (V.B.C.) and all other applicable Wheat Ridge Ordinances, for work under this permit. ...._~._,...,.~"~~~.~r~~---".....-._-,. ,.. "1 ! Building Permit Number: : Date or !Ii! U(p ! Phone3:D Lt22.-6G 3Lj Phone:l~ .~\.CO -5"3 2./ O~ Construction Value: I '10. Permit Fee: Plan Review Fee: Use Tax: Total: (OWNER) (CONTRA~T~R) ~IGNED. . DATE: 9 1\ \ Ot, ;Description: Building Department Vse Only Zoning Comments: ,SIC: Approval: IZoning: Sq.Ft.: 'Building Comments: :Approval: :Public Works ComfQents: Approval: I I J , Electrical License No: Company: iPlumbing License No: ICompany: t IEXPiratiOn Date: Approval: Mechanical License No: Company: iExpiratlon Date: Approval: Expiration Date: Approval: (1) This permit was issued in accordance with the provisions setforth in your 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 ofthe City. (2) 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. file:/I/EI/wwwrooVcitydev/buildin9_permit..application.htm (1 of 2) [7/2/2002 10:22:41 AM]