HomeMy WebLinkAbout3940 Dover StreetFrom: no-reolvCalci.wheatridae.co.us
To: CommDev Permits
Subject: Online Form Submittal: PERMIT APPLICATION Electrical Service Change/Upgrade/Electrical Work
Date: Friday, May 27, 2022 8:34:51 AM
CAUTION:This email originated from outside of the organization. Do not click links or open attachments unless you
recognize the sender and know the content is safe. Report any suspicious activities to the IT Division.
PERMIT APPLICATION Electrical Service
Change/Upgrade/Electrical Work
This application is exclusively for RESIDENTIAL ELECTRICAL SERVICE
CHANGE OR UPGRADE (200 amps or less).
YOU MUST ATTACH A VALID CREDIT CARD AUTHORIZATION FORM IN
ORDER FOR THE PERMIT TO BE PROCESSED.
Your Permit will be emailed to the email address provided below once it is
processed.
THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN
WORK UNTIL PERMIT HAS BEEN ISSUED.
Is this application for
Yes
electrical service
change or upgrade -
200 amps or less?
PROPERTY INFORMATION
Is this Residential or
Residential
Commercial?
Property Address
3940 Dover Street Wheat Ridge, CO 80033 USA
Property Owner Name
Kerrie Gil
Property Owner Phone
419-297-6395
Number (enter WITH
dashes, eg 303-123-
4567)
Attach City of Wheat
Electron ic-Payment-Form-2021.odf
Ridge Electronic
Payment Form - "DO
NOT ATTACH A
PICTURE OF A
CREDIT CARD"
CONTRACTOR INFORMATION
Contractor Business We R Electric LLC
Name
Contractor's License 202107
Number (This is a 5 or
6 digit number for the
City of Wheat Ridge)
Contractor Phone 720-219-9890
Number (enter WITH
dashes, eg 303-123-
4567)
Contractor Email
office@werelectric.com
Address
Retype Contractor
office@werelectric.com
Email Address
DESCRIPTION OF WORK
Is this an electrical
Upgrade
service upgrade or
change?
Number of Amps
200
Location of work
Backyard
(garage, house, etc)
Provide additional
Nia
details, if needed.
Project Value (contract
2000
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 work Yes
may not begin on this
property until a permit
has been issued and
posted on the property.
I certify that I have Yes
been authorized by the
legal owner of the
property to submit this
application and to
perform the work
described above.
I attest that everything Yes
stated in this
application is true and
correct and that
falsifying information in
this application is an
act of fraud and may
be punishable by fine,
imprisonment, or both.
Person Applying for Jason shepherd
Pe rm it
Email not displaying correctly? View it in your browser.
)Q
i CITY OF WHEAT RIDGE
Building Inspection Division a
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: 2 03 - e W ler ^ n , Z ,.-4
Job Address: 3Rgo v
Permit r:
Numbe
%
v �
❑ No one available for inspection: Time 1a AlVltv
Re -Inspection required: Yes S
When corrections have been made, call for re -inspection at 303 -234 -
Date: I Inspector: r%�
DO NOT REMOVE THIS NOTICE
*** COMMENTS ***
*** CONDITIONS ***
ALL sewer repair/replacements for which a permit is issued MUST be inspected by and receive
written approval from the City of Wheat Ridge BUILDING DIVISION, regardless of inspection
by any Sanitation District representative. Inspection and approval of work by any
Sanitation District representative DOES NOT grant authority to cover work without the
approval of the Building Division.
**For trenchless sewer replacements - The contractor will verify proper slope of new sewer
piping in conformance with the IRC and IPC of 1/4 inch per foot unless otherwise allowed
specifically by the applicable code. The plumbing contractor will provide verification of
proper slope and drainage in writing as a condition of approval of the permitted work.**
City of Wheat Ridge
Residential Sewer Repair
PERMIT - 201901055
PERMIT NO:
201901055
ISSUED:
05/23/2019
JOB ADDRESS:
3940 Dover St
EXPIRES:
05/22/2020
JOB DESCRIPTION:
60 FT sewer repair; install
dual sweep cleanouts
*** CONTACTS ***
OWNER (303)591-8456 BURGI PHILIP H
SUB (303)519-0240 R. ANDREW,RUSSELL
120161 THE ELITE
PIPE MD
*** PARCEL INFO
***
ZONE CODE: IUA
/ Unassigned
USE:
UA / Unassigned
SUBDIVISION CODE:
2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#:
0 /
*** FEE SUMMARY
*** ESTIMATED PROJECT VALUATION:
3,700.00
FEES
Total Valuation
0.00
Use Tax
77.70
Permit Fee
109.20
** TOTAL **
186.90
*** COMMENTS ***
*** CONDITIONS ***
ALL sewer repair/replacements for which a permit is issued MUST be inspected by and receive
written approval from the City of Wheat Ridge BUILDING DIVISION, regardless of inspection
by any Sanitation District representative. Inspection and approval of work by any
Sanitation District representative DOES NOT grant authority to cover work without the
approval of the Building Division.
**For trenchless sewer replacements - The contractor will verify proper slope of new sewer
piping in conformance with the IRC and IPC of 1/4 inch per foot unless otherwise allowed
specifically by the applicable code. The plumbing contractor will provide verification of
proper slope and drainage in writing as a condition of approval of the permitted work.**
1*6 / le City of Wheat Ridge
Residential Sewer Repair PERMIT - 201901055
PERMIT NO: 201901055 ISSUED: 05/23/2019
JOB ADDRESS: 3940 Dover St EXPIRES: 05/22/2020
JOB DESCRIPTION: 60 FT sewer repair; install dual sweep cleanouts
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
thispermit. I further attest that I am legally authorized to include all entities named within this document as parties to the work to be
perto ed and that all work performed is disclosed in this document and/or its' accompanying approved plans and specifications.
Z3 �
Signature of OWNER or ONTRAC Circle one) Date
I. This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is
subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures.
2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing, and
received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building
Official and may be subject to a fee equal to one-half of the originalpermit fee.
3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard
requirements, fees androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of
the Chief Building Official and is not guaranteed.
4. No work of 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 o regulation of this jurisdiction. Approval of work is subject to field inspection.
��4:4:
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
City of
Wheatidge
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: permits(a7ci.wheatridge.co.us
FOR OFFICE USE ONLY
Date: 5/a
Plan/Permit # l n JS
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
3 l (, V
Property Owner Email:
Mailing Address: (if different than property address)
Address
City, State, Zip:
Architect/Engineer:
Architect/Engineer E-mail:
(5�. Whee,,t al'
Phone:
Phone: L3 / moi'- � 4-156
Contractor:---,— �t V i
MT
Contractors City License #: / Phone: 7Z0 - 66 Z - cl 3 8 -
Contractor E-mail Address: CvxfJ t
Sub Contractors:
Electrical:
W.R. City License #
Other City Licensed Sub:
City License #
Plumbing:
W.R. City License #
. C-Ok",
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.)
❑ RESIDENTIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.)
❑ MECHANICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT
LUMBING SYSTEM/APPLIANCE REPAIR or REPLACMENT
ELECTRICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT
❑ OTHER (Describe)
(For ALL projects, please provide a detailed description of work to be performed, including current use of areas,
proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and
amount of materials to be used, etc.)
IsVJe e CC- 0L/k5
Sq. Ft./LF
Amps
Btu's
Squares
Gallons
Other
Project Value: (Contract value or the cost of all materials and labor included in the entire project)
$ 3760
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 er (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR)
Signature (first and last name): DATE:
ZONING COMMMENTS:
Reviewer:
BUILDING DEPARTMENT COMMENTS:
Reviewer.
DEPARTMENT USE ONLY
OCCUPANCY CLASSIFICATION:
Building Division Valuation: $
City of Wheat Ridge
Residential Sewer Repair PERMIT - 201901023
PERMIT NO: 201901023 ISSUED: 05/20/2019
JOB ADDRESS: 3940 Dover St EXPIRES: 05/19/2020
JOB DESCRIPTION: Residential sewer repair in front yard, 20 feet installing set of clean
outs.
*** CONTACTS ***
OWNER (303)591-8456 BURGI PHILIP H
SUB (720)296-7972 TREVOR HARBEY 130129 AFFORD -A -ROOTER
*** 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: 3,000.00
FEES
Total Valuation 0.00
Use Tax 63.00
Permit Fee 93.35
** TOTAL ** 156.35
*** COMMENTS ***
*** CONDITIONS ***
ALL sewer repair/replacements for which a permit is issued MUST be inspected by and receive
written approval from the City of Wheat Ridge BUILDING DIVISION, regardless of inspection
by any Sanitation District representative. Inspection and approval of work by any
Sanitation District representative DOES NOT grant authority to cover work without the
approval of the Building Division.
**For trenchless sewer replacements - The contractor will verify proper slope of new sewer
piping in conformance with the IRC and IPC of 1/4 inch per foot unless otherwise allowed
specifically by the applicable code. The plumbing contractor will provide verification of
proper slope and drainage in writing as a condition of approval of the permitted work.**
City of Wheat Ridge
Residential Sewer Repair PERMIT - 201901023
PERMIT NO: 201901023 ISSUED: 05/20/2019
JOB ADDRESS: 3940 Dover St EXPIRES: 05/19/2020
JOB DESCRIPTION: Residential sewer repair in front yard, 20 feet installing set of clean
outs.
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 ennrt. I further attest that I am legally authorized to include all entities named within this document as parties to the work to be
performed and that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications.
Signature of OWNER or CONTRACTOR (Circle one) Date
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 androcedures for approval of any new permit. Re -issuance or extension of expired pen -nits 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.
d5. The permit ho iy er 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
ce or gra ting of a permit shall not be construed to be a permit for, or an approval of, an violation of any provision of any
code or 4iy ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection.
Signature of CCief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
Dina Kemp
From: no-reply@ci.wheatridge.co.us
Sent: Monday, May 20, 2019 3:05 PM
To: CommDev Permits
Subject: Online Form Submittal: Residential Sewer or Water Line Repair Permit Application
Categories: Dina
Residential Sewer or Water Line Repair Permit Application
This application is exclusively for RESIDENTIAL SEWER OR WATER LINE
REPAIR - IN YARD ONLY - NO RIGHT OF WAY WORK.
YOU MUST ATTACH A VALID CREDIT CARD AUTHORIZATION FORM IN
ORDER FOR THE PERMIT TO BE PROCESSED.
Your Permit will be emailed to the email address provided below once it is
processed.
THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN
WORK UNTIL PERMIT HAS BEEN ISSUED.
Is this application for Yes
residential sewer line or
water line repair - in yard
only?
PROPERTY INFORMATION
Property Address
Property Owner Name
Property Owner Phone
Number (enter WITH
dashes, eg 303-123-4567)
Property Owner Email
Address
Attach Credit Card
Authorization Form -
**DO NOT ATTACH
RANDOM
DOCUMENTS**
3940 Dover Street
Phillip Burgi
303-591-8456
Field not completed.
CC form for 3940 Dover St.pdf
CONTRACTOR INFORMATION
I
Contractor Business Afford -A -Rooter
Name
Contractor's License 130129
Number (This is a 5 or 6
digit number for the City
of Wheat Ridge)
Contractor Phone 720-296-7972
Number (enter WITH
dashes, eg 303-123-4567)
Contractor Email Address affordarooter99@gmail.com
Retype Contractor Email
Address
DESCRIPTION OF WORK
Is this a sewer line or
water line repair?
Length of repair
Location of repair
(backyard, frontyard, etc)
Provide additional details
including installation of
clean -outs.
affordarooter99@gmail.com
Sewer Line
ME
Front yard
Installing a set of clean outs
Project Value (contract 3000
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 work Yes
may not begin on this
property until a permit
2
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.
I attest that everything Yes
stated in this application
is true and correct and
that falsifying
information in this
application is an act of
fraud and may be
punishable by fine,
imprisonment, or both.
Person Applying for Robin Fulton
Permit
Email not displaying correctly? View it in your browser.
City of Wheat Ridge
Residential Roofing PERMIT - 201701377
PERMIT NO: 201701377 ISSUED: 06/01/2017
JOB ADDRESS: 3940 Dover ST EXPIRES: 06/01/2018
JOB DESCRIPTION: Remove all layers and reroof 4/12 pitch - 22 squares using OC Duration 30
year
*** CONTACTS ***
OWTNER (303) 421-6425 BURGI PHILIP H
SUB (303)997-8012 Aaron Anders 100039 Acclaimed Roofing of Colorado
*** 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: 10,996.00
FEES
Total Valuation 0.00
Use Tax 230.92
Permit Fee 220.15
** TOTAL ** 451.07
*** 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 jN-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 manufacturera€-s 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's 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.
N PECT10� RE ORD
1 S
INSPECTION REQUEST LINE: (303) 234-5933
Inspections will not be performed unless this card is posted on the project
Call the inspection request line before 11:59 p.m. to receive an inspection the following bu!
Occupancy/Type
Inspector Must Sign ALL Spaces pertinent to this project
Foundation Inspections
Date Inspector Comments tl
Initials
Pier
Wall Sheathing
Concrete Encased Ground (CEG)
Foundation / P.E. Letter
Mid -Roof
Lath / Wall Tie
Do Not Pour Concrete Prior To Approval Of The Above Inspections
Underground/Slab Inspections FDate Inspector Comments
Initials
Electrical
Sewer Service
Plumbing
r%— K11-4 I Inrinrnrr%iiinA nr Rnlr►w/In_Slah Wnrk Prinr Tn Annrnval Of The Above Inspections
Rough Inspections
Date
Inspector
Initials
Comments
Wall Sheathing
Mid -Roof
Lath / Wall Tie
Rough Electric'
Rough Plumbing/Gas Line
Rough Mechanical
Rough Framing
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
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 — Fiease De sure inai rougn Inspections are GofllllleleU IIVIII llle Flit=: LJIJUIIiI cll lu VlOULI lU01 rwvv vvnayc
by the Building Division.
"For Inspection Time Window — Please email insptimerequest@ci.wheatridge.co.US by 8:00 A.M. the morning of the
inspection with the property address in the subject line of the email. Time window is based on the inspector's mute.
Occupancy Is Not Permitted Until A Certificate of Occupancy I;
Protect Thin- C:!:ltrl F-^rn The Weather
CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fa
INSPECTION NOTICE
Inspection Type: AOF
Job Address: 3 01416 S t
Permit Number: 2017013 77
❑ No one available for inspe.tion: ' e AM/PM
_r
Re -Inspection required:
When corrections have been made, Cali-fo�ie-inspection at
Date:-((.-,-//, ./ � Ins ector: L� aAft
DO NOT REMOVE THIS NOTICE
City of Wheat Ridge
Residential Roofing PERMIT - 201701377
PERMIT NO: 201701377 ISSUED: 06/01/2017
JOB ADDRESS: 3940 Dover ST EXPIRES: 06/01/2018
JOB DESCRIPTION: Remove all layers and reroof 4/12 pitch - 22 squares using OC Duration 30
year
*** CONTACTS ***
OWNER (303)421-6425 BURGI PHILIP H
SUB (303)997-8012 Aaron Anders 100039 Acclaimed Roofing of Colorado
*** 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: 10,996.00
FEES
Total Valuation 0.00
Use Tax 230.92
Permit Fee 220.15 _
** TOTAL ** 451.07
*** 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 k/2 -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 manufactureraErms 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's 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.
City of Wheat Ridge
Residential Roofing PERMIT - 201701377
PERMIT NO: 201701377 ISSUED: 06/01/2017
JOB ADDRESS: 3940 Dover ST EXPIRES: 06/01/2018
JOB DESCRIPTION: Remove all layers and reroof 4/12 pitch - 22 squares using OC Duration 30
year
I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications,
applicable building-eodes„and all appl' ble municipal codes, policies and procedures, and that I am the legal owner or have been authorized
by the legal owner of tie roperty a authorized to obtain this pennit and perform the work described and approved in conjunction with
this ermit-l'further att t that I e lly authorized to include all entities named within this document as parties to the work to be
performed and that ork to er rmed is disclosed in this document and/or its' accompanying approved plans and specifications.
naturl- f OWNER or CONTRACTOR (Circle one) Date
This permit was issued based on the information provided in the pen -nit application and accompanying plans and specifications and is
subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures.
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 permit fee.
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.
No work of an manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval.
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.
The issuance or granting of a permit.shgll not if_4 d o be a permit for, or an approval of, an violation of any provision of any
applicable code or any ordinance 'dr'tegulation'o tion. Approval of work is subject to fyeId inspection.
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
Inspection time requests will be accepted by email only. Please email requests to insptimerequest@ci.wheatridge.co.us
between 7:30am and 8:00am, the morning of the inspection. Please put the address of the inspection in the subject line.
City of
COMMUNITY DEVELOPMENT
Building d Inspection Services Division
7500 W. 29"' Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933
Email: permits .ci.wrheatridge.co.us
FOR OFFICE USE ONLY I
Data:
Plan Review Fee:
-7 0
Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed.
Property Address: J ei `f o Dc u- e- S r
Phone: 3 -,qa I
Property Owner Email: .41 1_-_ UP
E2 U A U�
Nulling Address: (if different than properly address)
Address:
City, State, Zip:
Architect/Engineer E-mail: Phone:
Contractor: 1C. C (A t #'k"p c` o(r►
Contractors City License 0: I 00 2 11� Phone: 3 -'qq "� go i
Contractor E-mail Aa
Electrical:
W.R. City License #
Other City Licensed Sub:
City License #
4, cc is i n/i e� rco4f'ir\ �
Plumbing:
W.R. City License #
Other City Licensed Sub:
City License #
,C
Mechanical:
W.R. City License #
Complete all information on BOTH sides of this form
qa.�-
❑ COMMERCIAL /RESIDENTIAL
DesclriRtion 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.)
❑ RESIDENTIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.)
❑ MECHANICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT
PLUMBING SYSTEM/APPLIANCE REPAIR or REPLACMENT
ELECTRICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT
OTHER (Describe)
(For ALL projects, please provide a getalW 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.) /I -
Sq. FtJLF
Amps
Btu's Gallons
Squares 1;k LS Other
Project Valine: (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 perforin the described work and am also authorized by the legal owner of any
entity included on this application to list that entity on this application.
CIRCLE ONE: (OWNER) (CONTRACTOR) or(UTHORTZED RKRESENTATTVE f (OWNER) (CONTRACTOR)
PRINT NAME:
ZONING COMMMENTS:
Reviewer.
BUILDING DEPARTMENT COMMENTS:
Reviewer:
PUBLIC WORKS COMMENTS:
Reviewer.
PROOF OF SUBMISSIObI FORMS
SIGNATURE:
DEPARTMENT USE ONLY
Fire Department ❑ Received ❑ Not Required
Water District ❑ Received ❑ Not Required
Sanitation District 0 Received ❑ Not Required
DATE: ! l
OCCUPANCY CLASSIFICATION:
TYPE OF CONSTRUCTION:
SPRINKLERED:
OCCUPANTLOAD:
Building Division Valuation: $
4' CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office - (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type:'
M, t 7' _®6 /
Job Address: 14"G%o XQ0V41?__
Permit Number: d /;% (V / 3 �,u'
❑ No one available for inspection: Time 10. /PM
Re -Inspection required: Yes No
When corrections have been made, call for re- spection at 303-234-5933
Date:(,/LInspector: " /
DO NOT REMOVE THIS NOTICE
~ DEPARTMENT OF PLANNINb AND DEVELOPMENT
BUILDING INSPECTIONf,NE - 303-234-5933
CITY OF WHE T RIDGE
7500 WEST 29T AVENUE
WHEAT RIDGE, CO 802 5. (303-235-2855)
!
Building Permit Number:
Date:
11236
9/26/2000
i
Property Owner: 'Bv-~
Property Address: 3940 DOVER ST
Contractor License No.: 18068 i
Company: Metrop lis Heating
Phone: 421-6425
Phone: 233 1307
OWNER/CONTRACTOR SIGNATURE OF U DERSTANDING AND AGREEMENT
i
I hereby certify that the setback distances proposed!by this permit application are accurate.
and do not violate applicable ordinances, rules or re ulations of the City of Wheat Ridge or
covenants, easements or restrictions of record; that II measurements shown, and allegations
made are accurate; that I have read and 89ree to a .de by all conditions printed on this
application, and that I assume full responslbili to m II the Wheat Ridge Building
Code (U.B,C.) and all other applicable Wh' r work under this permll.
DATrf?J~
Construction Value:
Permit Fee:
Plan Review Fee:
Use Tax:
Total:
$2,000.00
$69.25
$0.00
$30.00
$99.25
(OWNER)(CONTRACTOR) SIGN
Description:
!
i
WOOD TO GAS CON'VERSION- GAS LINE.
INSERT I
i
Use:
MASONRY FIREPLACE/INSTALL DIRECT VENT
UILDING DEPARTMENT USE ONLY
SIC:
Sq. Ft.:
Approval:
Zoning:
Approval:
Approval:
Occupancy:
Walls:
Roof:
Stories:
Residential Units:
Electrical License No :
Company:
plUmbing License No :
~mpanY :
E piration Date:
A proval:
Mechanical License No :
Company:
Expiration Date :
Approval:
Expiration Date :
Approval :
(4)
(5)
(61
This permit was issued in accordance with the p 'sions set forth in yopur application and is subject to the laws of the State of Colorado and to the Zoning
Regulations and Buildin~ Code of Wheat Ridge, olorado or any other applicable ordinances of the City.
This permit shall expire if (A) the work authorized s not commenced within sixty (60) days from issue date or (B) the building authorized is suspended or
abandoned for a period of 120 d8).':s.
If this permit expires, a new permit may be acqui 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 suspens on 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 ew permit.
No work of any manner shall be done that will ch ge the natural flow of water causing a drainage problem.
Contractor shall notify the Building Inspector twen -four (24) hours in advance for all inspections and shall receive written approval on inspection card before
proceedHng with successive phases ot the lob.
The issuance of a permit or the approval of drawl gs 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 ordinance, law, rule or regulation.
(1)
(21
(3)
Chief Building Inspector
DEPARTMENT 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)
~T\ON
Proper1'j Owner: ~ i
Property Address: 3<0\ L\ (::) :t:::c-re...r ~r'
Contractor License No, :~ 18c.. - i g Ole 1,
Company :M e.~\>c \ i So
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
Building Permit Number
Dale
Phone:
c....~o.. \ ,G '-I.~S-
Phone ~ .s3~(3 01
Construction Value' c9. CiCl()
Permit Fee:
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
aophcation, and that I assume full responsibility for co pliance w. e Wheat Ridge Building
Code (U.8.C.) and all other applicable Wheat.. work under this permit.
Use Tax:
(OWNER)(CONTRACTOR) SIGNED
DAT~tY6~a:J
Total:
Use:
/as~
/C'~._d'5 .,.
4/V1 /Yl5~
Description: woad -+t, ~os Q..<\VcU~(O,^'" gcs
Mo.-:"llI'\ry -h<"fICL(.~ / dl,e c/- U2t/1f-I/J,JrL/-!-
BUILDING DEPARTMENT USE ONLY
,
11'---
/
:zljfill)g',"-()mmen~
Approval:
Zoning:
Bi!l.rflm.g~_91l'1me!1ts;j
Approval:
R!fISJICW'{OJl<!~~2!1!m~n~;)
Approval:
Occupancy: Walls:
SIC:
Sq, Ft :
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)
(2)
13)
This permit was issued in accardance 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 BuildinfJ Code of \Nheat Ridge, Colorado or any other allPhcable oRManees of the CIty. ,,_'
This permit Shall expire If (A) the work authonzed IS not commenced witl"lIn Sixty (60) days from issue date or (8) the building authonzed IS suspended or
abandoned for a period of 120 days.
It ttns 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
anginal plans and specifications and any suspension or abandonment has not exceeded one (1) year. If changes are made or jf suspension or abandonment
exceeds one (1) year, full fees sl'lllll be paid for a new permit
No worx 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) I'lours in advance for alllnspeetions and shall receive written approval on inspection card before
proceed ling 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 Of any other ordinance, law, rule or regulation.
(4)
15)
(6)
Chief Building Inspector
;:$'."'" ,.",':ilI,~pll\!~ !P.lIlJ!~~!~"'!Jl!:,l'4~.~,.:i!~!'Ii~.~t.IIli!'W>I'/IlIJlll'f,~~
, I
DEPARTMENT OF PLANNIN AND DEVELOPMENT Building Permit Number: 2633
. BUILDING INSPECTION IVISION - 235-2855
CITY OF WH T RIDGE Date: 2/14/96
7500 WEST 29 AVENUE
WHEAT RIDGE, CO 80215
Property Owner: BURG PHILIP H
Property Address: 3940 OVER ST
Contractor License No. : 17941
Company: Bel Air Plumbing & Heating
Phone:
Phone: 4284221
OWNER/CONTRACTOR SIGNATURE OF U DERSTANDING AND AGREEMENT
I hereby certify that the setback dlstancea by this pennll a~llcatlon are accurate,
and do not violate applicable ordinances, rules or ulations of the City of Wheat RIdge or
covenants, easements or restrtctlons of record; tha all m<tasurements shown, and allegations
made ere accurate; that I have read end agrae to =b all conditions printed on this
application, and that I aaeume full responsibilllY for ance with the Wheat Ridge Building
Code (U.B,C,) and all other applicabla Wheat Rid ord nanC8S fo WO<t< under this permit.
(OWNER)(CONTRACTOR) SIGNED ,3 DATE;t Iv-1'.
Total:
$1,000.00
$25.00
$0.00
$15.00
$40.00
Construction Value:
Permit Fee :
Plan Review Fee :
Use Tax :
Description :
BATH REMODEL
UILDING DEPARTMENT USE ONLY
Approval:
Occupancy:
Walls:
Roof:
Stories:
Residential Units :
lumbing License No :
ompany :
Mechanical License No :
Company:
Electrical License No :
Company:
Expiration Date:
Approval:
.
Expiration Date :
Approval:
.
(1) This permit _ _In _ wtth the P s aet for1h In yopur application and llsubjod to the laws 01 the SIa18 of Colorado and to the ZonIng
Regul_ and BuIldIna Code of Wheal RIdae, I _ Of any other __ ordinances 01 the City,
(2) ThIS permit shall expire R (A) the wOO< authoriZed Is not oommenoed _ sixty (eo) daya fIcm Issue date Of (B) the building _Is suspended Of
a_lor a peiIod of12O days,
(3) R this permit expires. a new permit may be acqu lor a reo of one-haRthe amount normally required. _ no changes have been OfwlH be made In the
original plans and spedlI..dtiol..ll!1d any su . Of abandonment has not exceeded one (1) year, lfchanges are _ Of. auapenaIon Of abandonment
exoeeda one (1) year, fuR _ shati be peld . now permit
(45) No work of any menner shall be done lhal will the neIunll flow of water causIna a dralnege problem.
() Contractor shall nofIIY the Building I~ .four (24) hours In advance lor aIImspectlons and shaH receive _ approval on inspection card -
(8) ~~ ~:==-pprovaIthe~. . and opecJllcatIollS shall not be _ to be. permlllor. nor an approval 01, any _ of the pIOYiaIons
the 1Id1 codes or any nee, law nde or regulation.
ef Building Inspector
THIS PERMIT VALID 0 L Y WHEN SIGNED BY THE CHIEF BUILDING INSPECTOR
CALL: 2 -5933 24 HOURS PRIOR TO INSPECTION
If jif:tID
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:
Property Address:
Contractor License No. :
Company:
,
JIA Y j1't/A'u/
J'tJ 'I ~ iJ t1 V' .tlf J 7.-
/1 r'll
P~j - /0/1 f'/~ r; .r I/:/t/ ,htlL
Phone:
Phone: If ,tJ7. 4/~~/
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
Construction Value" I; t"t1't?;t? 0
I hereby certify that the setback distances proposed by this permit application are accurate, P .t F
and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or erml ee:
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 pnnted on this Use Tax:
application, and that I assume full responsibility for compliance with the Wheat Ridge Building
Code (U.8.C.) and all other applicable Wheat Ridge ordinance~s. for" ark under this pennrt.
/1 "t:;;- // ~ , / Total :
(OWNER)(CONTRACTOR) SIGNED a> f if~ DATE ;t -)v-
(/
Description: j7 /11 ,f 1J.f JI c/ ,tJ If. t j j.tl ~ t7 tv" phi '7 ;; / .K 1,/ /! .y y'
BUILDING DEPARTMENT USE ONLY
:?"'iJ1LtJ~~~I;",,,f JII' t
Approval :
Zoning:
;~It ,,:'.. '~""!:~t-''J''iI:)ll'J:'
Approval:
~b,llc:~Wam.,.....mtnJr\bl'l!
Approval:
Occupancy: Walls:
Roof:
Stories:
Residential Units:
Plumbing License No. / 7 q i/ I
Company: ! JI -If / If I' ~ /Y
Mechanical License No :
Company:
Electrical License No :
Company:
Expiration Date:
Approval:
..J prans RAAU!red;'-:"1
Expiration Date:
Approval:
JJ Plans Required J
Expiration Date:
Approval:
:.I 'pflrnsmqulrilDll!liil
(1)
(2)
(3)
This permit was ISSUed In accordance with the proviSions set forth In yopur applicatIon and 1$ subject to the laws of the Slate of Colorado and to the Zoning
Regulations and BUilding Code of VVheat Ridge. Coloraoo or any other applicable ordinances of the City.
This permit shall expire If (A) the work authonzed is not commenced wIthin SIXty (60) days trom Issue date or (8) the bUIlding aulhOnzed is suspended or
abandonea for a penod of 120 days.
If this permit expires. a new permit may be acquired for a fee of one.half the amount normallv 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; 01 any manner shall .be done that will change the natural flow of water causing a drainage problem
Contractor Shall nottry the BUilding Inspector twenty-four (24) hours In advance lor alllnspectJons and shall receive wntten approval on InspectJon card before
proceedllng with successive phases of the lOb.
The Issuance of a permit or the approval of drawmgs anCl speaficatlons shall not ce conslrueo 10 be a permit for. nor an approval of. any violation of lhe provISIons
Jf the bUlIClmg coCles or any other ordmance. law, rule or regulation
(41
(5)
(6\
Chief Building Inspector For Mayor
THIS PERMIT VALID ONLY WHEN SIGNED BY THE CHIEF BUILDING INSPECTOR AND MAYOR
CALL; 234-593324 HOURS PRIOR TO INSPECTION
'",.,g)~.!!~,.",_.""",","~,~I,,,.,;;I,,,i!l,,I," ",""k",!~~I.l,l!~~,l\!"~,.'~l!lf'''''''''f,,,,,,,,.,,,,~~.~~~'{f!I'I!!t,'iI:\~,~~~~"",,,,,~~.f>c'''1'~~~
- DEPARTMENT OF PLANNING AND DEVELOPMENT Building Permit Number: 2628
~ BUILDING tN$PECTION DIVISION. 235-2855
CITY OF WHEAT RIDGE Date: 2/13/96
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80215
"
Property OWner: BURGI PHILIP H
Property Address: 3940 DOVER ST
Contractor License No.: 17994
Company: Orville Zimmerman Const.
Phone:
Phone: 429 3440
OWNERlCONTRACTOR SIGNATURE OF uNDERSTANDING AND AGREEMENT
Construction Value:
Permit Fee :
Plan Review Fee:
UseTax:
I hereby certify that the setback dlstanoes proposed by this pennll .ppllcatlon .11 accurote,
and c:Io not violate applicable ordinances, rules or reg, uletions of the City of Wheat Ridge or
covenants, e.samentoor reslttclIono of IlCOrd; that all me.surements shown, and allegatlona
mode.... .ccurate; that I haVellad and .g.... to abide by .11 condlllons plinted on this
application, and that 1."umefuR rosponslbtlllY for'compllance with the Wheat Ridge Building
COde (U.B.C.) and oR other appIicobIo! Rldga ordlnanoes, for wor1< under thiS pennll.
(OWNER)(CONTRACTOR) SlONE ' DATE2--t ;A1'-
Total:
$2.000.00
$45.00
$0.00
$30.00
$75.00
Description :
REMODEL BATH OM AND BUILD 2 SMALL CLOSETS IN BEDROOM
BUILDING DEPARTMENT USE ONLY
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) lhI8 pennIt -1SoU4Id In ~ WIlh tho prqvieIona set forth In yopur appIk:otIon end Is BUbIed 10 tho _ of tho _ 01 CoIcndo ond to the Zormg
R_IndBulldlnac-oIWl1oat RldoO, CoIcndoOfany ___of the City,
(2) ThIi ponnIt _....... (A) tho_ .uthoriZed Is, not oommeo_ wtthlit IixIy (eo) daye fIcm Issue _ Of (8) tho building _Is auspended Of
_~fOf.::=a
(3) Wthls pannIIllqliiII, a _ may be IIOqlIinld fOr eloe of ona-haW tho amount normoIIy ....uIred. IlIOVIdod no ~ _ _ Ofwlll be __In tho
orfgInoI pIona and and any _Ion Of abandonmlnl has not exceeded one (1) yeer, 11 changIs 011_ Of....-- Of _omenl
_ one (1) yeer, fuI__ be jloId!Of e _ permit.
1451 No _ 01 any monner _ be done thII wlII cl1lInge tho __ oIw_ co...... 0 draIn8ge problem,
COntraclDr"" notlt't tho IluiIdIng ~ twenty-lour (24) hours In _lor ell fnspectionj end 1heI1_ _ 8PPfV\IIII on InspocIIon cord before
(S) ~ ~C~.r'drOwl.ga end opedtIcationa shaH not be oonstrued to be 0 permit for. nor an 8PPfV\IIII 01. any violation of tho pnlYIoIons
01 the Of~.I8w.'ruIeOfrogU-"
uildlng Inspector
THIS PERMIT VALID ONLY WHEN SIGNED BY THE CHIEF BUILDING INSPECTOR
CALL: 234-11933 24 HOURS PRIOR TO INSPECTION
mE~~]
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: @.Jt.t Cb~
Property Address: j.q+O JJ~4f.
Contractor License No.: I 7 qq 4-
Company: ~~Cnu;t.(! ,4
Phone: 42/_f.,t./..<-5
Phone: 42.9 - 3,/+0
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
Construction Value :.;(000 .00
Permit Fee:
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 the Wheat Ridge Building
Code (U.B.C.) and all other applicable Wheat Ridge ordinances. for work under this permit.
(OWNER)(CONTRACTOR) SIGNED~~ DATE 2 -/3 .q~
DescriPtion:~M afj~ 2-~~~
Use Tax:
Total:
BUILDING DEPARTMENT USE ONLY
f".!JlliJ.~'::i';''''I' 'II> r
Approval:
Zoning:
;'11 ~', . '''~:t-I~Jj\' F
Approval:
gqb.IIt"~WmBi~lllm.lftS~
Approval:
Occupancy: Walls:
Roof:
Stories:
Residential Units:
Electrical license No :
Company:
Plumbing License No :
Company:
Mechanical license No :
Company:
Expiration Date:
Approval:
-.J prans RAAu!redT."l
Expiration Date:
Approval:
.JI P!lhsRequlred
.I
Expiration Date:
Approval:
~ :PJlIns;Rt"quJI'iRfI:lliII
(11
(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 Sudding Code of lNheat Ridge, Colorado or any other applicable ordinances of the City.
This permit shall expire If (A) the work authonzed is not commenced Within SIXty (60) days from Issue dale or (8) the bUilding aulhOnzed is suspended or
abandoned lor a penod of 120 days.
If this pennrt expires. a new pennlt may be acquired for a fee of one-half the amount normallv reQuired, provided no changes have been or will be made in the
original plans and speclfications and any suspension or abandonment has not exceeded one (1) year. If changes are made or if suspenSion or abandonment
exceeds one l1) year. full fees shall be paid for a new permit.
No work of any manner snail be done that Will change the natural flow of water causing a drainage problem
Contractor snaU notify the Building Inspector twenty-four (24) hours In advance lor all inspections and shall receive written approval on InspectIon card before
oroceedllng WIth succesSive phases of the lOb.
The Issuance 01 a permit or the approval of draWings and specificatIons snail nOl be construe<! to be a permit for. nor an approval of, any Violation of the prOVISIons
0f the bUlldrng codes or any other ordinance. law. rule or regulation.
141
(5)
161
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