HomeMy WebLinkAbout4020 Dover StreetA i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type: �D
Job Address: L-� (:� -) 0
Permit Number: c, f, \ G CU 0 Z—
❑ No one available for inspection: Time }`! AM/PM
Re -Inspection required: Yes No-'
When corrections have been made, schedule for re -inspection online at:
http://www, ci, wheatridge, co, usrnspection
Date:U 1C; Inspector:'`
DO NOT REMOVE THIS NOTICE
City of Wheat Ridge
Residential Sewer Repair PERMIT - 201902002
PERMIT NO: 201902002 ISSUED: 09/19/2019
JOB ADDRESS: 4020 Dover St EXPIRES: 09/18/2020
JOB DESCRIPTION: Residential sewer repair from yard to tap, 40 feet.
*** CONTACTS ***
OWNER (303)670-9520 MONDRAGON KATHLEEN L
SUB (303)766-7500 JEFF BELK 021818 PLUMBLINE SERVICES LLC
*** 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: 2,250.00
FEES
Total Valuation 0.00
Use Tax 47.25
Permit Fee 93.35
** TOTAL ** 140.60
*** 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.**
PERMIT NO:
JOB ADDRESS:
JOB DESCRIPTION:
City of Wheat Ridge
Residential Sewer Repair PERMIT - 201902002
201902002
4020 Dover St
ISSUED: 09/19/2019
EXPIRES: 09/18/2020
Residential sewer repair from yard to tap, 40 feet.
I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications;
applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized
by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with
this�ppermit. I further attest that I am legally authorized to include all entities named within this document as parties to the work to be
pertbrmed and that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications.
Signature of OWT;TR or CONTRACTOR (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 grantin f 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 r inance or regulation of this jurisdiction. Approval of work is subject to field inspection.
k"
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
3o�: -'-t2c-t- +? SZ
City of
W heat Ildge
COMMUNITY DEVELOPMENT
Building & Inspection Services
7500 W. 29th Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933
Email: permits(cDci.wheatridge.co.us
FOR OFFICE USE ONLY
Dat
Plan/Permit #
()/1N,GO
Plan Review Fee:
Building Permit Application
*** Complete all applicable highlighted areas on both sides of this form.
Incomplete applications may not be processed. ***
Property Address: �'(rQ1 2d 14 1- ✓' 11. g)A4 a 4-r s'el cs R__
Property Owner (please print): (�� } yvt c>h�a �,.. Or �q�, Phone:
Property Owner Email:
Tenant Name (Commercial Projects Only)
Property Owner Mailing Address: (if different than property address)
Address:
City, State, Zip:
Architect/Engineer E-mail:
Phone:
Contractor Name: 91%.0y%iI
City of Wheat Ridge License #: Phone:
Contractor E-mail Address: JC_ A J VIOL IQ Q 1 %4W r 1'.yt (. S4_y*y1C4_" •. c � vl
For Plan Review Questions & Comments (please print):
CONTACT NAME (please print): 'T'.y-1 Phone: 3 a3- JS L —1 -LS 2c(
CONTACT EMAIL(p/ease print):
Sub Contractors (Must provide Wheat Ridge License No & Signed Subcontractor Authorization form):
Electrical: Plumbing: Mechanical:
W.R. City License # W.R. City License # W.R. City License #
Other City Licensed Sub: Other City Licensed Sub:
City License # City License #
Complete all highlighted fields, if applicable.
❑COMMERCIAL XC RESIDENTIAL
Provide description of work: For ALL projects, provide a detailed description of work to be
performed, including current use of areas, proposed uses, square footage, existing condition and
proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc.
R,eP�; ✓ sc.�✓c.rr ��>^L crro Pv7 yc..rd 4-C'
Y �•�� burs�:,.,�, yard o�ra�.>»d �a �+
Sq. FULF
BTUs
Gallons
Amps Squares For Solar: KIN # of Panels Requires Structural
For Commercial Projects Only: Occupancy Type: Construction Type:
Occupancy Load: Square Footage:
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. 1, the applicant for this building permit application, warrant the
truthfulness of the information provided on the application.
CIRCLE ONE: (OWNER) (CONTRACTOR) or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR)
Signature (first and last name): L,&6 DATE: —[ /
Printed Name:
ZONING COMMMENTS:
Reviewer:
BUILDING DEPARTMENT COMMENTS:
Reviewer:
PUBLIC WORKS COMMENTS:
Reviewer:
DEPARTMENT USE ONLY
OCCUPANCY CLASSIFICATION:
CONSTRUCTION TYPE:
Building Division Valuation:
2017 O� 2-� �
c , 'o bbl- si- INSPECTION
INSPECTION ONLINE FORM: http://www.ci,wh
INSPECTION REQUEST -0
RECORD
idggco. us/inspection
(303)_234-5933
Occu ancy/Type
f2-kC✓
Inspections will not be performed "less this card is posted on the project site.
"Request an inspection before 11:59 p.m. (midniot) to receive an inspection the following business day.**
Inspector Must Sign ALL Sp ce e r6i Jo this pro'
Foundation Inspections Date Inspector
Initials
Pier
Concrete Encased Ground (CEG)
Foundation / P.E. Letter
Do Not Pour Concrete Prior To Approval Of The Above Ins
Underground/Slab Inspections Date
Inspector Comments
Initials
Electrical
Wall Sheathing
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 Annroval Of The Ahnvp Insncaretinnc
Rough Inspections Date
Inspector
Initials
Comments
Wall Sheathing
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.
Mid -Roof. /C,17
Floodplain Inspection (if applicable)
Lath / Wall Tie
Fire Inspection / Fire Protection Dist.
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 r
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 - 201703246
PERMIT NO: 201703246 ISSUED: 07/05/2017
JOB ADDRESS: 4020 Dover ST EXPIRES: 07/05/2018
JOB DESCRIPTION: Residential Re -roof to install Malarkey Legacy Dimensional asphalt shingles
with ROOF DECKING - 30 sq.
*** CONTACTS ***
OWNER (303)888-7902 MONDRAGON KATHLEEN L
SUB (720)352-2916 Phil Crout 170290 PJC Construction
*** 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: 10,053.75
FEES
Total Valuation 0.00
Use Tax 211.13
Permit Fee 220.15
** TOTAL ** 431.28
*** 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 spa -ed
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 filial 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.
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: ko F
Job Address:�-
Permit Number:
e
❑ No one available for inspection: Time A"jpM
Re -Inspection required: Yes No
when corrections have been made, call for re -inspection at 3o3-234-5933
Date: F, /�Inspector:— "%A%9i4,y1__
DO NOT REMOVE THIS NOTICE
A e ` CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type:N
Job Address: O VE
Permit Number: O 11%
❑ No one available for inspection, -Time
r
Re -Inspection required: Yes (No,
When corrections have been made, call for rre\e-inspection/at 303-234-5933
Date:'6' le, 17 Inspector:
DO NOT REMOVE THIS NOTICE
a City of Wheat Ridge
.. r
/ Residential Roofing PERMIT - 201703246
I+
PERMIT NO: 201703246 ISSUED: 07/05/2017
JOB ADDRESS: 4020 Dover ST EXPIRES: 07/05/2018
JOB DESCRIPTION: Residential Re -roof to install Malarkey Legacy Dimensional asphalt shingles
with ROOF DECKING - 30 sq.
*** CONTACTS ***
OWNER (303)888-7902 MONDRAGON KATHLEEN L
SUB (720)352-2916 Phil Crout 170290 PJC Construction
*** 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: 10,053.75
FEES PAID
Total Valuation 0.00
Use Tax 211.13 _
Permit Fee 220.15
** TOTAL ** 431.28
*** 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.
City of 'Wheat Ridge
Residential Roofing PERMIT - 201703246
PERMIT NO: 201703246 ISSUED: 07/05/2017
JOB ADDRESS: 4020 Dover ST EXPIRES: 07/05/2018
JOB DESCRIPTION: Residential Re -roof to install Malarkey Legacy Dimensional asphalt shingles
with ROOF DECKING - 30 sq.
I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications
applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized
by the legal owner, he property and am authorized to obtain this permit and perform the work described and approved in conjunction with
this ermit. I furth r a t that I am legally authorized to include all entities named within this document as parties to the work to be
performed and th ' e performed is disclosed in this document and/or its' accompanying approved plans and specifications.
Signature of OWNER or COXTRACTOR (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 change of the natural flow of water without prior and specific approval.
5. The permit border 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 cade or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection.
04iuca�7—M044
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.
Kimberly Cook -�ol7o� Z�6
From:
no-reply@ci.wheatridge.co.us
Sent:
Thursday, June 22, 2017 9:59 AM
To:
Permits CommDev
Subject:
Online Form Submittal: Residential Roofing Permit Application
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. 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. Permits are currently being
processed within 5 business days, subject to change based on volume.
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 VAS v(f
residential roof?
How many dwelling units Single Family Home
are on the property?
PROPERTY INFORMATION
Property Address 4020 Dover St
Property Owner Name Kate Mondragon
Property Owner Phone 303-888-7902
Number
Property Owner Email Kmondragon@earthlink.net
Address
lql1ll L/U
Do you have a signed Yes
contract to reroof this
property?
It will need to be
provided at the time of
permit pick-up.
.d�7� I �� �7�II � 13e C u _ •
Contractor Name
Contractor's License
Number (for the City of
Wheat Ridge)
Contractor Phone
Number
PJC Construction
170290
7203522916
Contractor Email Address loftusgina12@gmail.com
Retype Contractor Email loftusgina12@gmail.com
Address
DESCRIPTION OF WORK
Are you re -decking the Yes /
roof?
Description of Roofing Malarkey Legacy dimensional asphalt shingles
Material
Select Type of Material: Asphalt
If "Other" is selected Field not completed.
above, describe here:
How many squares of the 30
material selected above?
Does any portion of the No /
property include a flat
roof?
If yes, how many squares Field not completed.
on the flat roof?
TOTAL SQUARES of all 30 /
roofing material for this
proj ect
PkI
Provide additional detail n/a
here on the description of
work. (Is this for a house
or garage? What is the
roof pitch? Etc)
Project Value (contract _Z500-7
value or cost of ALL � 0�1 ?5'materials and labor) / .J i
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 Phil Crout
Email not displaying correctly? View it in your browser.
3
C r RA
Pati+n
g
CONSTRUCTION - HONESTY, INTEGRITY & RELIABILITY
Homeowner �40rq'16rj Mobi )50 Email t4
. . ... . .... . ......... .......
Date "
Property Address 140,�Ib ... ... ..... ..........-._City
Approximate mate ofl.oss.
Ll- I . Damagge resulting from wind, hail or other 44,kt L
4 H4 P IN'- 0 am the owner of the above mentioned property ("Homeowner'"), and I hereby
authorize PJC Construction ("Contractor") to provide my restoration services in accordance with the terms and conditions set forth in
this Agreement. it is estimated. based on the initial inspection, that my restoration services proposed by Contractor will cost
approximately Please note that this constitutes a rough estimate of my total job cost. The total cost of my job
is subject to change, based on any supplemental claims made to )-fly insurance company and/or adjustments made to my claim by my
insurance company. Contractor can't assess the exact final amount that will be settled until my work has been completed. I'm aware
that I am never responsible to pay any out-qflpocket expense other than my policy deductible. I understand that Contractor will utilize
its insurance claim expertise in settling the amount of my claim with my insurance company. The payments that I will receive will
reflect the amounts that Contractor has settled upon, and I will endorse and make payable to PJC Construction all payments that I
receive for my claim, for work that is completed. If applicable, I understand that if my claim contains any amounts for Contractor
"Overhead and Profit'', these amounts will be paid to PJC Construction. Initial payment ("ACV") is due upon delivery of my
materials, and the final payment ("Depreciation") is due within 3 days of my receipt. All original checks received from the insurance
company shall be endorsed as follows: "Pay to the order of PJC Construction" followed by my signature. My deductible will be paid
to PJC Construction, upon completion of my restoration work. I direct my insurance company to include PJC. Construction on any and
all of my checks or other instruments issued in payment of my claim. PJC Construction is also hereby authorized by me to discuss this
specific claim and payments issued for it, on my behalf, with my insurance company and my mortgage company.
Scope of work: PJC Construction will install all materials & complete all labor in accordance with the specifications outlined below,
and the entire scope of the settled insurance claim will be completed, unless otherwise stated.
v Njc ,
Shingle Manufacturer Year tt tl.Color i 4
N/1Tear off all existing layers
��l scall decking (W 16" OSB)
[Znstallnew felt
[-4 It eaveirake drip edge per code Color-,
[-�Jnstall new pipe jacks & vents
Nkfnstall 6 nails per shingle
[ j,&"e-flash chimneys & headwall metals, as needed, per code
ft?,(Clean out all debris from gutters
[vfRemove & haul away all debris from premises
116pstall gutter & downspouts - Color T
['`Make a magnetic sweep of the yard and
driveway arm to remove displaced nails
I -Irl 'Pull and post a city work permit
Q15 year workmanship warranty
-71A Insurance company k I k+ f—, -—--..-----Claim# J�& ,
Agent name/phone# VV V4N Adjuster nametphone# l 06 -Got e"Kr 440
�tL4 i '7
Mortgage Company
Account
r
Approximate start date- completion date --. .... ......
�
Additional terms or special instructions; N ow, vw
This Agreement is trot ralid Y'the insurance company does not agree to a -full roof replacement.
Date of Acceptance __� �13 Signature
..... . ... .. .,A`7 . 7,
PJC Construction Representative ---Signature ,7
1633 Fillmore Street, Denver., CO 80206 - www,pjc-constTuction.net
Phil: direct 720-352-2916, pliitiicconstructioii.-fict 't Jake: direct 720-364-8365, iake
,4
�picconstructiqn. net
FOR OFFICE USE ONLY
City of Date: r f ..
Wh6at
COMMUNijy DEVELOPJEN9�'g planlpermlt#
Building 8 Inspection Services DivisionDivision0,075 c-5
7500 W.2g'�' Ave., Wheat Ridge, CO 80033 Plan Review
Office: 303-235-2855 * Fax. 303-237-8929
Inspection Line: 303-234-5933
Building r it Application
Mailing Address: (if different than property address)
Address.
tai tete;, i
Archie ngin E-mail: w._ Phone.
Contractors City License M. phoria. � � r .w. „ �
Contractor tor" E-mail Address: C5, 14 C 1 �3,, v
Sub Contractors*.
Electrical: Plumbing: Mechanical:
W.R. City Lice # W.R. City License # W.R. City License
Other City Licensed Sub. Other City Licensed Sub:
City License # City License #
Complete all information on BOTH sides of this farm
"" r a s wr ♦ -s w t an wr r
• e.
R' 1 ;t � ot Ott / c. s .s 1:.
m
Sq, FULF Stu's Gallons
INSPECTION NOTICE
Inspection Type
Job Address eaov,�5,e 57 °
Permit Number
L
Inspecto
NOT REMOVE THIS NOTICE
BUILDING DEPARTMENT
(303) 235-2855
CITY OF WHEAT RIDGE
* *
Correction Notice
Job Located at f'oz U U('"'C.H'---
I have this day inspected this structure and these premises and
have found the following violations of City and/or State laws gov-
erning same:
;-/c;k::: UJ',0>P6CV CA-I- ;nv:.....ste--- JUb IS
re!Jut"'~cf! 1,';' he re~reoP ~'/ve
/0 < <'1 h .0.....
/6
You are hereby notified to correct the foregoing violations.
When corrections have been made, call for Inspection.
Date / / S 7&
p:2~
I or lor Building Dept.
DO NOT REMOVE THIS TAG
FORM WR8-22
BUILDING DEPARTMENT
. - - ----1
I
I
(303) 235-2855
CITY OF WHEAT RIDGE
* *
Correction Notice
Job Located at '-/1) 10 OOdtZr<'
I have this day inspected this structure and these premises and
have found the following violations of City ancllor State laws gov-
i erning same:
~.
~ C:;/..n/~er J/r.4'" J1()/ I j,rc"",.J/' '.h?/>'
, /", ""
. W YOJ'1S S cr~s 014 S L,cu-e.. #1",- <; - hf'f",.
17r.4$S
, .J. // ,"fli'I"'''' 1./~/5 ,rr;::-. Ih/a;:>J,
reo.
I
r.
I
!
You are hereby notified to correct the foregoing violations,
When corrections have been made, call for inspection.
Date
1//t./"lF
" I
16 /~~~f'1r'
Inspector for Bu ' Jng Copt.
DO NOT REMOVE THIS TAG
FORM WR6.22
_______-.J
.
"
I
I
,.
I
DEPARTMENT OF PLANNING AND DEVELOPMENT Building Permit Number: 8086
BUILDING INSPECTION DIVISION - 235-2855
CITY OF WHEAT RIDGE Date: 11/4/98
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80215
Property Owner:
Property Address: 4020 DOVER ST
Contractor License No.: 18121
Company: The Electri-Serve Corp.
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
Phone: 3034328601
Phone: 892 0027
Construction Value:
Permit Fee:
Plan Review Fee:
Use Tax:
Total:
$7,877.00
$105.00
$0.00
$118.16
$223.16
I hereby certify that the setback distances proposed by this permit application are accurate,
and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or
covenants, easements or restrictions of record; that all measurements shown, and allegations
made are accurate; that 1 have read and agree to abide by all conditions printed on this
application, and that I assume full responsibility for compliance with the Wheat Ridge Building
Code (U.B.C.) and all other applicable Wheat Ridge ordinances, for work under this permit.
(OWNER)(CONTRACTOR) SIGNED
DATE
Use:
Descri ption :
Electrical service upgrade, wiring for addition and remodel
BUILDING DEPARTMENT USE ONLY
.......
Approval:
Zoning:
SIC:
Sq. Ft.:
........
Approval:
Approval:
Occupancy:
Walls:
Roof:
Stories:
Residential Units:
Electrical License No :
Company:
Plumbing License No :
Company:
Mechanical License No :
Company:
Expiration Date:
Approval:
Expiration Date:
Approval:
Expiration Date:
Approval:
(1) This permit was issued in accordance with the provisions set forth in yopur application and is subject to the laws of the State of Colorado and to the Zoning
Regulations and Building Code of Wheat Ridge, Colorado or any other applicable ordinances of the City.
(2) This permit shall expire if (A) the work authorized is not commenced within sixty (60) days from issue date or (6) the building authorized is suspended or
abandoned for a period of 120 days.
(3) If this permit expires, a new permit may be acquired for a fee of one.half the amount normally required, provided no changes have been or will be made in the
original plans and specifications and any suspension or abandonment has not exceeded one (1) year. If changes are made or if suspension or abandonment
exceeds one (1) year, full fees shall be paid for a new permit.
(4) No work of any manner shall be done that will change the natural flow of water causing a drainage problem.
(5) Contractor shall notify the Building Inspector twenty-four (24) hours in advance for all inspections and shall receive written approval on inspection card before
proceediing with successive phases of the job.
(6) 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
1) Oft~~~in~CO~~'anY Z:?O~inance, law, ,ule 0' ,e9UlaliOi (f)
Chief Building IrlJpector '1
THIS PERMIT VALID ONLY WHEN SIGNED BY THE CHIEF BUILDING INSPECTOR AND MAYOR
CALL: 234-5933 24 HOURS PRIOR TO INSPECTION
DEPARTMENT OF PLANNING AND DEVELOPMENT Building Permit Number:
BUILDING INSPECTION DIVISION - 235-2855
CITY OF WHEAT RIDGE Date:
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80215
Property Owner: ~"'-1 Lv"d-..
Property Address: l{o:2.,o t:>o_'~ <;~"-\- Phone: 303-'-\ 3?-~ (
Contractor License No.: I 2,12-[
Company :The- E~~ - ~ c.r-f>. Phone: 303 -'is''j::t _0=,
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
Construction Value: 7,%'T1pOO
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 responsibili for compliance With the Wheat Ridge Building
Code (U.8.C.) and aU other applicable e id ordinan . for work under this permit.
(OWNER€0--~CT~ SIGNE ~ATE~
Description : E\~<cJ SQI-v'<-<L 0f'0~( -h- ~~/'\ c..~ ('Q~.".-'
BUILDING DEPARTMENT USE ONLY
Penmit Fee:
Use Tax:
Total:
.)) I ~!JV.1. '.
Approval:
Zoning:
gli1i1~ml1iMl
Approval:
~JrC;W:(jl'kll:elmln\Jiilll~
Approval:
Occupancy:
Walls:
Roof:
Stories:
Residential Units:
Electrical License No. I 81 '7.-(
Company . n,..J::\""*,,J-~ (/:wi"
Plumbing License No :
Company:
Mechanical license No :
Company:
Expiration Date:
Approval:
1?Jliji:~liTte(I.--- ~
~f:...".... .",
Expiration Date:
Approval:
.. .eOO1s'R!fqu~::;"""l
w "',,... .. .. - . --,- .,;'.'~:.r.
Expiration Date:
Approval:
.. P'JIljl(GlI11I~
(11
(21
(3)
This permit was issued in accordance wittllhe provIsions set forth in yopur 8Pphcabon and is subject to the laws of the State of Colorado and to the Zoning
Regulations and Building Code of \Nheat RIdge. Colorado or any other applicable ordinances of the CIty. .
This permit shall expire it (A) the work authorized 1$ not commenced Within Sixty (60) days from issue dale or (8) the building authorized is suspended or
abandoned for a ,period of 120 days. , . .
If this permit expires, a new permit may be acquired tor a fee of one-half the amount normally required. Provided no changes have been or will be made in the
original plans and specifications and any suspension or abandonment has not exceeded one (1) year. If changes are made or if suspension Of aoandonment
exceeds one (1) year, full fees shall be paid for a new permit.
No work of any manner shaH be done that will change the natural flow of water causing a drainage problem.
Contractor shall notify the Building Inspector twenty-four (24) hou~ in advance for all inspections and snaU receIVe wntten approval on inspection carCJ before
proceedung With successive pnases of the lOb. .
The issuance of a permit or the approval 01 draWings and specifications shall not be construed to be a permit for. nor an approval of. any violation of the provIsIons
01 the building codes or any other ordinance, law. rule or regulation.
(41
(5)
(61
Chief Building I nspeclor For Mayor
THIS PERMIT VALID ONLY WHEN SIGNED BY THE CHIEF BUILDING INSPECTOR AND MAYOR
CALL: 234-5933 24 HOURS PRIOR TO INSPECTION
Certificate of Completion
AND/OR
Compliance
CITY OF WHEAT RIDGE
7500 W. 29TH AVENUE
WHEAT RIDGE, COLORADO 80215
THIS CERTIFICATE VERIFIES THAT THE PROPERTY DESCRIBED BELOW, DOES
COMPLY WITH THE WHEAT RIDGE BUILDING CODE, ZONING AND OTHER
RELATED LAND USE AND DEVELOPMENT LAWS OF THE CITY OF WHEAT RIDGE
FOR THE FOLLOWING PURPOSE.
PERMIT # 7163
Addition and Renovation to SFD
OWNER: Jay Lund
ADDRESS: 4020 Dover Street
PROPERTY ADDRESS: 4020 Dover Street
ZONING ADMINISTRATOR
DATE Aug. 28.2001 CHIEF BUILDING OFFICIAL
c
QEPARTMENT OF PLANNING AND DEVELOPMENT Building Permit Number: 7840
BUILDING INSPECTION DIVISION - 235-2855
CITY OF WHEAT RIDGE Date: 9/25/98
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80215
Property Owner:
Property Address: 4020 N. Dover Street
Contractor License No. : 19827
Company: Walrath Heating and Air Cond Co. Inc.
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
Phone: 432-8601
Phone: 232-4343
(OWNER)(CONTRACTOR) SIGNED
DATE
Total:
$11,456.00
$188.00
$0.00
$171.84
$359.84
Construction Value:
Permit Fee:
Plan Review Fee:
Use Tax:
I hereby certify that the setback distances proposed by this permit application are accurate,
and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or
covenants, easements or restrictions of record; that all measurements shown, and allegations
made are accurate; that I have read and 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.
Use:
Description:
Complete forced air heating system with central air conditioning
BUILDING DEPARTMENT USE ONLY
IIIIlIiIIIIIIIII
Approval:
Zoning:
SIC:
Sq. Ft.:
Ii!!.~
Approval:
-~
Approval:
Occupancy:
Walls:
Roof:
Stories:
Residential Units:
Electrical License No :
Company:
Plumbing License No :
Company:
Mechanical License No :
Company:
Expiration Date:
Approval:
Expiration Date:
Approval:
Expiration Date:
Approval:
(1)
(2)
(3)
This permit was issued in accordance with the provisions set forth in yopur application and is subject to the laws of the State of Colorado and to the Zoning
Regulations and Building Code of Wheat Ridge, Colorado or any other applicable ordinances of the City.
This permit shall expire if (A) the work authorized is not commenced within sixty (60) days from issue date or (8) the building authorized is suspended or
abandoned for a period of 120 days.
If this permit expires, a new permit may be acquired for a fee of one-half the amount normally required, provided no changes have been or will be made in the
original plans and specifications and any suspension or abandonment has not exceeded one (1) year. If changes are made or if suspension or abandonment
exceeds one (1) year, full fees shall be paid for a new permit.
No work of any manner shall be done that will change the natural flow of water caUSing a drainage problem.
Contractor shall notify the Building Inspector twenty-four (24) hours in advance for all inspections and shall receive written approval on inspection card before
proceediing with successive phases of the/-ob.
The issuance of a permit or the approval 0 drawings and specifications shall not be construed to be a permit for, nor an approval of, any violation of the provisions
f the building codes or any other ordinance, law, rule or regulati n
r:
(4)
(5)
(6)
THIS PERMIT VALID ONLY WHEN SIGNED BYTHE CHIEF BUILDING INSPECTOR AND MAYOR
CALL: 234-5933 24 HOURS PRIOR TO INSPECTION
DEPARTMENT OF PLANNING AND DEVELOPMENT Building Permit Number:
. BUILDING INSPECTION DIVISION. 235-2855
CITY OF WHEAT RlbGE'.J Date: 9, '2,s 1'198
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80215
Property Owner:
Property Address:
Contractor License No. :
<<
Company:
JAYLi.qJD
4o;J.D N, ~(.I~ ~T;
198:t.7
1IJ~t1Tf/ /!r?j" f/: ArI2..&NtJ. Co.
,
Phone: 303 43::J..~1
Phone: 3037.3'Z.4343
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
Construction Value:
Permit Fee:
Plan Review Fee:
Use Tax:
114&;.~.=
iSS.cZJ
I hereby certify that the, setback ~Istances 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 I~ree to abide by all conditions printed on this
application, and that I assume full responsibility for compliance with the Wheat Ridge Building
Code (U.B.C.) and all other applicable ~ Ri 9a ordi or we under this permit.
(OWNER)(CONTRACTOR) SIGNED"oU DATE 9, ;tS. 'lS
Description: CowdJt.c7E A-t12.. t-Ir:3f77/JQ
<2,svrMc- l1-re COA)f); - . r:
BUILDING DEPARTMENT USE ONLY
17f,e.4
3 59,84
Total:
S tis I En1 U/I77f-
ZOlli!!.'lJil=~en~
Approval:
Zoning:
BiiIRlIi'iln.C~W?1entsll
Approval:
rab~ca~~~brrnm~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 :
RI sp,J~..~,.mt_
Expiration Date:
Approval:
IIIlel~B.il:clU!OCr.t_
Expiration Date:
Approval:
iii !e.I!i!1Jl~UI~"
(4)
(5)
(61
This permit was Issued In accordance with the p)ovisions set forth In Vapur application and is subiect to the laws of the State of Colorado and to the Zoning
Regulations and Building Code of Wheat Ridge. Colorado Of any other applicable ordinances of the City,
this permit ,hall expire ff (A) the work authonzed is not commenced within sixty (60) days from issue dale or (8) the building authorized Is suspended or
abandoned for a period of 120 day's.
If this permit expires. a new perrmt may be acquired for a 'ee of one.half the amount normally required, provided no changes have been or will be made In the
original plans and specifications and any suspension or abandonment has not exceeded one (1) year. If changes are made or If suspension or abandonment
exceeds one (1) year, full fees shall be paid lor a new permit. .
No work of any manner shall be done that will change the natural flow of water causln!l a drainage problem_
Contr8etor shall notify the BUilding Insfector twenty.four (24) hours in advance for all inspections and shall receive written approval on inspection card before
proceedilng with successive phases 0 thel"Ob"
The Issuance of a permit or the approval 0 drawings and specifications shall not be construed to be a permit for, nor an approval of, any violation of the provisions
of the building codes or any other ordinance, law, rule or regulation.
(1)
(2)
(3)
Chief Building Inspector For Mayor
THIS PERMIT VALID ONLY WHEN SIGNED BY THE CHIEF BUILDING INSPECTOR AND MAYOR
CALL: 234-5933 24 HOURS PRIOR TO INSPECTION
It
7163
QEPARTMENT 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
6/2/98
Property Owner:
Property Address: 4020 Dover Street
Contractor License No. : 20007
Company: Jay C. Lund
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 the Wheat Ridge Building
Code (U.B.C,) and all other applicable Wheat Ridge ordinances, for work under this permit.
(OWNER)(CONTRACTOR) SIGNED
DATE
Phone: 432-8601
Phone: 432-8601
Construction Value:
Permit Fee:
Plan Review Fee:
Use Tax:
$40,000.00
$487.00
$10500
$600.00
$1,192.00
Total:
Use:
Description:
Addition and renovation to existing residence at 4020 Dover Street
BUILDING DEPARTMENT USE ONLY
SIC:
Sq. Ft.: 1556
Proposed addition complies with all R-2 regs. Landscaping: 1 street
tree 170' of street frontage ( 1 street tree)
See attached P.W. review sheet, sign and copy to Jay C. Lund
Approval: GK
Occupancy:
Walls:
Roof:
Stories:
Electrical License No :
Company:
Plumbing License No : 17178
Company :Good Plumbing Service
Co., Inc.
Expiration Date: 4/16/99
Approval:
Expiration Date:
Approval :
Residential Units:
Mechanical License No :
Company:
Expiration Date:
Approval:
This pennlt was issued in accordance with the provisions set forth in yopur application and is subject to the laws of the State of Colorado and to the Zoning
Regulations and Building Code of Wheat Rid';)e, 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 date or (B) the building authorized is suspended or
abandoned for a period of 120 days.
If this permit expires, a new permit may be acquired for a fee of one-half the amount normally required, provided no changes have been or will be made in the
original plans and specifications and any suspension or abandonment has not exceeded one (1) year. If changes are made or if suspension or abandonment
exceeds one (1) year, full fees shall be paid for a new permit.
No work of any manner shall be done that will change the natural flow of water causing a drainage problem.
Contractor shall notify the Building Inspector twenty-four (24) hours in advance for all Inspections and shall receive written approval on inspection card before
proceedling with successive phases of the job.
The issuance of a permit or the approval of drawings and specifications shall not be construed to be a permit for, nor an approval of, any violation of the provisions
of the building codes or any other ordinance, law. rule or regulation. I
J
,
(1)
(2)
(3)
l~l
(6)
nspector
THIS PERMIT VALID ONLY WHEN SIGNED BY THE CHIEF BUILDING INSPECTOR AND MAYOR
CALL: 234-5933 24 HOURS PRIOR TO INSPECTION
DEPARTMENT OF PLANNING AND DEVELOPMENT
BUILDING INSPECTION DIVISION - 235-2855
CITY OF WHEAT RIDGE
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80215
Property Owner: )- v' PI cf
Property Address: '10020 rf) cJVi9'1
Contractor License No. : '&-/7/7 c?
Company: C; 00 J OJI VIM h;,.,.9::,
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
Building Permit Number:
Date:
I h.reby certify thltlh. s.lblck dlstlnces proposed by this pennn appllcetlon Ire Iccurlt.,
and do not vfolate appncable ordinances, rules or regulations of the City of Wheal Ridge or
covenants, easements or restrictions of record: thai all measurements shown, and allegations
made Ire .ccurate; that I have read and 89ree to abide by all conditions printed on this
Ippllcallon, and that I assume full responsIbility for compliance wnh the Wheal Rldg. Building
Code (U.B.C.) an~ all other applicable Wheat Ridge Ordlna~ces. for work under lhi;A Tit!......_7
(OWNER)(CONTRACTOR) SIGNED________~. a.JtXvI.<re-DATE~ Use:
&1l5 "qpoE... .:;:-h'3-&/) u/"'~ i/C'rl-fd-Wq~r oJ/tfe
Description :.~ .-,) tV C - / /?/b / - .5~&
,L-o<r -' ....."'us - / . .-
gI.. t{/qi.e ,- lIeo,,'fe,$ (OWI1f'Y' "'VcfP/~c>"" ;'1<tl/re
oj- hq..s Vq/vc "'''' t.,,$ per ,.,,'f-
Phone ::103- C/ Q.- jJ C; 0/
Phone: y 5 ,5- ,$/;0 '7
Construction Value: ~
Permit Fee:
Use Tax:
Total:
so.oo.
~
BUILDING DEPARTMENT USE ONLY
':,!:l,ml'.~'lJH"'Ali;t
Approval:
Zoning:
PJJ]~lmIlQomm'nl$~
Approval:
/\[) J
~J~y0jO
.'/'(:;1 'i.a,;~l.J.iIiIJili).~
Approval:
Occupancy: Walls:
Roof:
Stories:
Residential Units:
Electrical License No :
Company:
Plumbing License No =/7/?f
Company:GOOD f'Cq<11I5/1Jd,.
Expiration Date: f-/~ - f1
Approval:
Expiration Date:
Approval:
SIC:
Sq. Fl:
MechanIcal License No :
Company:
Expiration Date:
Approval:
(I) this po.... "",Issued In occordance with lI1e """",len, ,.1''''''' In yopIK application and I, ,ubled 10 lI1e laws ofll1e Sllla of Cofotado end 10 lI1e ZonlnO
Regulations .nd BuRdin; Code of Wheat Ridge. Colorado or any other appticable ordinances of the City.
(2) ThIs pennIt shill expire H (A) lI1e wo<1< a_ad Is nol commenced --. ,ixty (60) day' fnlm Issue da.. Of (9) lI1e building a_ad IS autpended Of
abandoned for . perlod of 120 days.
(3) If this pemit expires. I new petTI'l/t fNlY be acquired for. fee of one-hitf the amount normally required. provtded no changes haw been or will be made In the
ortglnal peans.nd lped(lCations Ind eny suspension or abandonment has not exceeded one (1) '(elf. If changes are made or If suspension or.~
exceeds one (1) year, run fees shan be pakf ror a new permit.
1.5) No wOO< of any maMer shan be done that win change the natural flow of water causing a drainage problem.
t Conlrldor lhan notify the Building Inspector twenty.four (2.) hours In IdvInce fOl" an Inspections and lha. recefve written IpptOYIl on tnlpectlon Clrd before
_Hng with successive phase, of lI1e lob.
(6) lhe Issuance of . pennit or the 8pprova:i of drawtngs and specifiClUons shin not be construed to be . pennit for, not In approva1 of, In)' vtotation 01 the ptOYfsIons
of lha building codes Of any _ ordlnonce,lIw, rula Of regulation.
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
H,.,. ''''''''''''~''''^'",' "";>",,,,,,, "'''''~''.""~,,,",~,,' I. .IJJ"^~""''''''''"'+!"'''''''''''''''''.'''.'''''"''''''''1 ""'''''''~'~"/'''''~''''''''''''''''''''"",'''',,,,,,' ",,,~'F"..,,,..,..,,...,'llIn~,.m_,...,,,,. "
QEPARTMISNT OF PLANNING AND DEV@LgPMENT Building P~rmit Number: . 7163 ..
. BUILDING INSPECTION DIVISioN - 235-2855 ,
CITY OF WHEAT RIDGE Date: 6/2/98
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80215
Property OWner:
Property Address: 4020 Dover Street
Contractor License No. : 20007
Company: Jay C. Lund
OWNER/CONtRACTOR SIGNAtURE OF UNDERSTANDING AND AGREEMENT
Phone: 432-8601
Phone: 432-8601
Construction Value :
Permit Fee :
Plan Review Fee:
Use Tax:
Total:
$40,000.00
$487.00
$105.00
$600.00
$1,192.00
I hereby certify thet the ee!back distances proposed by this permtt application are accurate,
and do not violete applicable ordinances. rules or regulations of the City of Wheat Ridge or
covenllJ1ts. easements or restrk:tlons of record; that all rne.$urements 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 FUclge ordlnances. for worl< under this permtt.
(OWNER)(CONTRACTOR) SIGNED
DATE
Use:
Description:
Addition and renovation to existing residence at 4020 Dover Street
BUILDING DEPARTMENT USE ONLY
SIC: Sq. Ft.: 1556
prOJlO$ed addition complies with all R-2 regs. Landscaping: 1 street
tree 170' of street frontage ( 1 street tree)
Approval: GK
Occupancy: Walls:
See attached P .W. review sheet, sign and copy to Jay C. Lund
Roof:
Stories:
Residential Units :
Electrical License No :
Company:
Plumbing License No :
Company:
Mechanical License No :
Company:
Expiration Date:
Approval:
Expiration Date:
Approval :
Expiration Date:
Approval:
(1) This p$l11\It _ iosu8d In _ wltll the jllOVislons selforth In YOllur IIPl>licatIon and is sublect to the_ of the State of COIorlIdo and to the Zoning
flegula1lOns and BulIdlng c- of _ flldge, COIorlIdo or any other ~pIlcable ordlnanoes of the City.
(2) This p$l11\It. shall.expife I fA) the work luthOriZed Is not commencad within sixty (60) days from Issue date or (B) the building luthorized Is suspended or
abandoned lOr I perkl<f 0(120 dap.
(3) W thla perI!I~ expl.... a new permit may be acqulled for I fOe of o....hlW the lmount nonnally required. provided no chlngeS have been or will be made In the
original plans oiId specIIIcallons and any suspension or lbandonment has not exceeded one (1) year. If changes Ire made or W suspension or abandonment
exceed$Qn8 (1) year. fuR fHa.shailtbepald for 8 new permtt.
(4l No WOfttof any manner shall be done that will change 'the natural flow of water causing a dratnage problem.
(5 Contractor sheltnotify the BuDding Inspector twenty.rour (24) hours in advance for aU Inspections and shall receive written approval on inspecU~ card before
proc:aedllng with _ phases of the lob.
(6) l11e Issuanoe of a permit or the approval of drawings and spacIfk:atIons shall not be construed to be a p$l11\It for. nor an approval of, Iny _ of the provisions
of/!4"7;;i1Lmln~'fi'N~orregwdon. ~~ < ~
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
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
J"'1 &. LuNO
4020 PaVER. "'l, hl+!~Af RID6E.
I hereby certify that the setback distances proposed by this pennit application are accurate,
and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or
covenants, easements or restridions of record: that all measurements shown, and allegations
made are accurate; that I have read and a~ree to abide by all conditions printed on this
application, and that I assume full responsibility for compliance with the Wheat Ridge Building
Code (U.B.C.) and all other applicable Wheat Ridge ~~n~ for work under this permit.
(OWNERl(CONTRACTORlSIGNE&7r-, ~. DATE '::l,\1.9~ Use:
APOITlo~ -+ RENO\!P.-PDN To
lSXI-:'>TIN~ R.,ESIOl=:Nc.,E. AT
4oz.o OoJ t=:f'(.. 5 '
BUILDING DEPARTMENT USE ONLY
f~:nb'1q+Qommll11~] "5/~e;li/.'b
Approval: '?I"'-' 'f-'IOI"()bF-SO ).DPl rt 0,.1 c...&M rt-t ~
Zoning: R - d-, iN In.\- ~\.-t.. ~ -:2 ~, ! I
uH~CJl.PlIiLo' l &,If'mfi!!l" 7"
~R1IJ:1m.aQmme~~ ~~ ~ ptu.>~~ (I 7f 11'/.&) _1
Approval : ~
Property Owner:
Property Address:
Contractor License No. :
Company:
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
Description :
Approval:
Occupancy :
~ ~~'f.W.tr~\~ !>4I'f.
fiJ 1-/ ''fJ
Walls:
Roof:
Stories:
Electrical License No :
Company:
Plumbing License No :
Company:
Expiration Date:
Approval:
Expiration Date:
Approval:
Phone: ?6'J.4?Z.e,&ol
Phone: '30"3.4?2.o/061
Construction Value:
Permit Fee:
12 F
Use Tax:
40JODD,
--1 '0700
I C 5,00
/ (1 00 .L:O
$0.00
Total:
r ,
&- 5 ( CWl +-cd)
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Mechanical License No :
Company:
Expiration Date :
Approval:
This penntt was Issued In accon:Sance wiUl the provfsions set forth in yopur application and is subject to the laws of the State of Colorado and to the Zoning
Regulations and Buildl"9. Code of Wheat RId~e, Colorado 01" any other i1~tcabte ordinances of the City.
This pennit shaU expire If (A) the WOf1( authorized is not commenced within sixty (60) days from Issue date Of (8) the building authorized is lU$pencled or
abandoned for a period of 120 day's. .
If this permit expires, a new permt may be acquired for a fee of one-half the amount nonnally requited. provided no changes have been or will be made in the
onginal plans and specifications and any suspension or abandonment has not exceeded one (1) year. If changes are made or if suspension or abandonment
exceeds one {1} year, full fees shall be paid for a new permit.
No worK of any manner shall be done that will change the natural now of water causing a drainage problem.
Contractor shall notify the Building Inspector twenty.four (204) hours in advance for all inspections and shall receive wrinen approval on Inspection card before
proceediing with successive phases of the job.
The ~suance of a permit Of the approval o( drawings and specif1cations shall not be "'~s a permit for, norlJJEn pproval of, any Ykllation of the provisions
of !he bulkHng cod~S Of any other onlinance. law. rul. Of regulation, t1 .-_
. ;,6J,;i-Pff ~-
Chiet'Building Inspec or For Mayor
THIS PERMIT VALID ONLY WHEN SIGNED BYTHE CHIEF BUILDING INSPECTOR AND MAYOR
CALL: 234-5933 24 HOURS PRIOR TO INSPECTION
(1)
(2)
(3)
(4)
(5)
(6)
PUBLIC WORKS REVIEW FEE STRUCTURE FOR BUILDING PERMIT APPLICATIONS
Date '" -I '"L I "'\ ,
.
Applicant J ~ L""""o
Phone # ~~Z --~"O I
Location of Construction (address) 4- Co "Z.- ~ ~ ~ ~"T .
Purpose of Construction JM!d \.hOV\.\::.. e-LL~ . S l""e
Building Permit Value $ 4<') 0 oe
Commercial
Residential X
DEVELOPMENT REVIEW FEES (this section to be completed by City)
Development Review Processing Fee: $50.00
eo 0"
$ J .
Single Family Residential Review Fee: $25.00
[includes review of construction drawings for improvements in public right-of-way] $Z&':.I:> 0
Multi-Family/Commercial: .$50 minimum fee [confirmation of existing technical
documents]. $500.00 maximum fee [includes review of construction drawings for
improvements in public right-of-way, review of preliminary/final drainage study
and erosion control plan(s) if required]
Site Plan: $50.00 (Not applicable for single family residential)
Right-of -WaylEasement $40.00 + $5.00/page recording fee
Development Agreement Residential = $50.00 Commercial = $100.00 .
State Highway Access Permit: $75.00 application fee
Traffic Impact Review & Report: $100.00 processing fee
Flood Plain Variance: Class I = $75.00 Class II = $150.00
TOTAL REVIEW FEES: (due at time of building permit issuance)
$ ~ O'
$ _ O.
$ _ 0-
$ _ 0-
$ - 6-
$ - 0-
$ - 0-
$ ":1S. o?
Please note that additional fees will be assessed for those permits related to construction of
public improvements. If you have any questions. please feel free to contact the Development Review
office at 235-2868.
Signature of Applicant
Date
DEPARTMENT OF PUBLIC WORKS
BUILDING PERMIT APPLlCA TION REVIEW
Date:~{ -z.-/ ' g
Location: 4c>'Z 0 -r:;:o.....e.n s-c .
Attention: Building Department
I have reviewed the attached materials submitted in application for approval ofa~Gla~ ~.o"..\.. ej,s.-r.
at the above referenced address. Please note the summary comments below.
1. ....- Boundary Closure: ~ OK _ Not OK; refer to stipulations.
2.,..-/' Drainage:
a. Drainage plan and report needed _
b. Drainage plan not needed _
c. Drainage provisions have been reviewed and are found to be:
~ OK _ Not OK; refer to stipulations.
_ Yes ..x No
~ OK _ Not OK; refer to stipulations.
3. ~
4. .-::::;-
5. -=::::-
6. --
7 ---
8' -....--
9' ~
10. ___
.11. ---
12._
--
13.
14. -
CaselBuilding Permit No.:
5f'~
NPDES Permit Required:
Legal Description:
If not OK, please explain:
Public Improvements:
a. street paving needed: _ Yes
b. curb and gutter needed: _ Yes
c. sidewalk needed: Yes
d. street lights needed: Yes
e. storm sewer needed: Yes
f. escrow required: _ Yes
If an escrow is required. for what improvements?
Amount of escrow:
Development Agreement required: Yes
If Yes, for
Traffic impact analysis and report required: Yes
State Highway Access Permit needed: _ Yes
New roadway or alley R.O.W. dedication recommended: _ Yes
If yes, w t is recommended?
All e . tin dedicated roadways/alleys meet the standards of the City:~ Yes
Ifn , w . h do not and what IS requested: .
~No
-1L No
.JL No
-1L No
~No
~No
~No
~No
-X No
~No
No
, / z I "If>
81 ature eg Knudson Date f ,
NO APPROVAL: The Public Works Department has reviewed this request and does not give
its approval for the reasons stated:
Date
8if!'1ature Greg Knudson
Stipulations attached: _ Yes
.summa Comm nts:
(.
.....
~
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C:I...formslbldpnnt2.frm
,,~ ~~t'
The City of
7500 WEST 29TH AVENUE
.
WHEAT RIDGE, COLORADO 80215
GWheat
GRidge
SINGLE FAMILY MINOR EXCA V A nON AND FILL PERMIT
NAME OF APPLICANT: J ....., L..."n
ADDRESS OF EXCA V A TION/FILL:
40"20 V.....ea s.-r,
APPLICANT ADDRESS: ~C> '2,0 "'C),. -'t;(Z. >r.
DATE OF APPLICATION:
r..{-z./ "I~
All permits shall be applied for through the Public Works Department. An approved permit is
effective for a period of one (1) year from the date of issuance, and may be renewed. All fees
shall be in accordance with those fees established by the Uniform Building Code CUBC), or by
other applicable City adopted Resolution or Ordinances.
Grading Plan Review Fees*:
o to 100 cubic yards. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . m5.OiV
101 to 1,00 cubic yards. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ."$22:50
1,00 I to 10,000 cubic yards. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. $30.00
10,00 I to 20,000 cubic yards. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. $45.00
SUB-TOTAL:
Grading Permit Fees*:
o to 50 cubic yards. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ~
51 to 100 cubic yards. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . ... $22.50
IOJ to 1000 cubic yards -- $22.50 for the first 100 cubic yards, plus $10.50 for each additional
100 cubic yards or fraction thereof: C. Y. Amount Due: $
1,001 to 10,000 cubic yards -- $117.00 for the first 1,000 cubic yards, plus $9.00 for each
additional 1,000 cubic yards or fraction thereof: C. Y. Amount Due: $
10,00 I to 20,000 cubic yards. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $238.50
~.oo
TOTAL FEES DUE: $ _
(303) 234-5900 . ADMINISTRATION FAX: 234-5924 . POLICE DEPARTMENT FAX: 235-2949
Building sites whose total excavation and fill exceeds 20,000 cubic yards must be processed
under the provisions of Section 26-33 of the Wheat Ridge City Code. Upon conformance
with Section 26-33 of the City Code, grading plan review fees and grading permit fees shall
be established in conformance with Section 3310, Table A-33-A, and Table A-33-B
respectively of the Uniform Building Code.
* Uniform Building Code, Section 3310
I HEREBY ACKNOWLEDGE THAT THIS APPLICATION IS CORRECT, AND
UNDERST AND THAT THE REQUESTED WORK CAN NOT BEGIN UNTIL THIS
APPLICATION IS APPROVED BY THE CITY OF WHEAT RIDGE. I AGREE TO
COMPLY WITH THE LAWS OF THE STATE OF COLORADO, WITH ZONING
REGULATIONS AND WITH THE BUILDING CODE OF THE CITY OF WHEAT
RIDGE. ANY VIOLATION WILL BE CAUSE FOR IMMEDIATE REVOCATION OF
THIS PERMIT, AND COMMENCEMENT OF ENFORCEMENT PROCEEDINGS BY
THE CITY OF WHEAT RIDGE. THIS APPROVED PERMIT WILL BE KEPT IN MY
POSSESSION, OR PERMANENTLY ON THE JOB SITE.
~\.~
City Engineer
L-
.
APPLICANT:
CITY OF WHEAT RlDG .
Applicant's Signature
Owner's Signature (if different than above)
~ 7 '2- / 9'~
Approval Date
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CDLDIADD BI~IIBBIII~
& SUIVBTII~ IIC.
3410 10. lherman It. lulll 2 · Ingl8wood. Colorado lalla . 761-8055
Surveying Colorado Since 1972 . FAX: 761-0841
SCALE 1-.
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~~~:~telnthe National Flood In.urane. Program~
I herebr cerIIfy that.. property alCribecllw'eon / S ^' O'IocaWd whhlna ftoodhuan:l bol.Ind.-y, (ZOl"le
by IhII Federal Emergency Uanagemenl Agency (FEM~:
Flood......m........ Z - ~ - 8' 6' Commurjly........ C/ 6' S- 07 9
IMPROVf!IIFNT lOC.a.nON CERTIFICATE CTX MORTGAGE / LUND
I ~ctNtifyhl"lmptoV~lloeatlon~lew..prepw~lor
that It" not_land Iwvey pial or mprovllment survey plat. and that II II not 10 be r.u.d upon lor IM..t.abIiahmenc oIl~, buiIcling, or 0U'ler '~~~ 'ii~.l
~ :? ,., 7 ~\, {Ill REr./o':I/.
IIUf1MfOlrtitylhalhlmprovementsontheabo~dtscribedparcelonlhl'date 0 -/..J -: 7 _ .Xceptutiliry~.~.,~~arielolthliparcel"J.cepl
as thown, thai.,... are no encroachments upon 1M delaibed pI'eITll... by 1mpro.M*.ts on IInY ~ premI..., .xoeplas indical ., ~~ Of 19" of ""W- '&Semenl
aosalngorbudenlnganypar101sakl parceI,.xceptas noted. ~2. '\,: .lJ{J-....~~.
IIUl1hercettltylhalthelocallonollmPfOY""'II'hown~arebueduponthelocatlonolmorunenlliin"'...... andlhat1tU~ putpOr1lo~a~ SUl'Yewo PI.II. and II lubj~
10 arrt INocurw:lu that..ubMquent Impro.emenl Survey Pial WOUlddildoM. The~makeI nowarranryOl' ......,,1a1ion~ and .....,locabon~IIon!-1tw boI.ndary nl.l.Il'lleu
~~~~dlIhwmJ_ 1M It-""I deM line.' ~~i~~G~s Ki;rIj~
M Ihown and.ta1ed on" drawing.. -Found", " no monumanttwere found at 1M .ubfectproperty,.... ~dMclllnn were .:::, ~~AOO INQ~mrHQ &.''If:!!INQ.
ba.MduponananalytlcllClOlNl.tIonbetwMnOClCUplltlonllnu,..buII1lrnprovemenll(publlc&prtv.IlI).....r1ght4.wayinN.etc., ~ ,. ~ ~
An improvement Swvey Plat may yield d1l1etWrt raults. '. ._. ~
R80llfd 11"- Deed aM L_a1 n."r.rlD!Inn' .'
lhl. Inlormaion W&l1UppIIed 10 COIor_ EnglllMrlng .. surveying; no 1lU. Natdl WU catIducIad by CE!.
A11ln1ormallon pertaining 10 deed line. and euemenls.... derived from the ~ pial. unIeIa octwwiM noted and .tatad.
lhi. documenIla ~ undrw the I_WI of the FedWaI Copyright Act. Ttu drawtng thaII noI be l.tMd by 1M Cli... or any 0Chet
patty lor ANY purpoHOChrIrthan that which IN drawing was~. 1M ~of RED llaI'ntMd........ an WWUlhofized
reproduc1Ion. Md no c:er1ftc:atlon .xtends to 1hI pIfSOn holding Iuch copy.
LEGAL DESCRIPTION:
LOT 9, GLENDA SUBDIVISION,
COUNTY OF JEFFERSON, STATE OF COLORADO.
ALSO KNOWN AS 4020 DOVER ST
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ThIs commtftly.Jklu..nl:ll pw1iciplll' in the N,!ional Flood Inlwane. PrOQlam_
C
), aocordirlg 10.... mosl CUl'Wlt nood 1nI1M'at'lCe r.l'm~ (FIRM). prOOucld
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RECORD AND RETUIUf TO:
FirstSBnk of Wheat Ridge,
4350 Wadswortb Boulevard
Wbeat Ridge, CO 80033
M.A.
3054623/Lund
(Space Aboye lbis Line For Recordillg Data)
DEED OF TRUST
THIS DEED OF TRUST ("Security Instrument") is made on MAY 2, 1998
Jay CaaeroD Lund and Diana Wilson Lund, Joint Tenant a
. among the grantor,
("Borrower"), the Public Trustee of
FirstBank of Wheat Ridge,
JefferSOD
M.A.
County ("Trustee"), and the beneficiary,
which is organized and existing under the laws of tbe
ad~e~is 4350 Wadswortb Boulevard, Wheat
State of Colorado , aDd whose
Ridge, CO 80033
("Lender"). Borrower owes Lender the principal sum of
TWO IlUNDRED SBVElf THOUSAND AND NO/100
Dollars (U.S. $ 207,000.00 ).
This debt is evidellCed by Borrower's note dated the same date as this Security Instrument ("Note"), which provides
for monthly payments, with the full debt, if not paid earlier, due and payable on JUJfE 1, 2028
This Security Instrument secures to LeDder: (a) the repayment of the debt evidellCed by the Note, with interest, and all
renewals, extensions and modifications of the Note; (b) the payment of all other sums, with interest, advanced uDder
paragraph 7 to protect the security of this Security Instrument; and (c) the performance of Borrower's covenants and
agreements under this Security Instrument and the Note. For this purpose, Borrower, in consideration of the debt and the
trust herein created, irrevocably grants and conveys to Trustee, in trust, with power of sale, the following described property
located in Jefferson County, Colorado:
Tract 9, GLENDA SUBDIVISION, COunty of Jefferson, State of Colorado.
Together with.all ~ater and water rights of any typ~ which are ~ppurten8nt to. the p~operty or whi~h.are or may be US~ on
or in connectlon w'~h the property at the pr~$~t.t'.e or any tlMe h~re.fter lncludlng, bUt not llm't~ t9 the fo~lowlng:
adjudicated water rlghts and decrees and prlorltles therefor; unadJudlcated water rlghts and approprlatlons; rlghts In
water from tributary and nontributary sources,whether surface or underground;conditional water rights; rights to existing
under well permits lssued by the Stat~ Engin.e~ or other federal, state or .unicipal authorities;, rights a~d perMits ana
designated gro~nd ~ater baslns; all rlghts clalmed under contract"exch~nge,or plans o~ augmentatlon; all,dltches, canals
reservoirs, plpellnes, tunnels, wells and other stru~tures for dlve~tlng, and conveYlng ~ater and all rlghts of way a~d
ease.ents therefor; and all shares of stock or other lnstruments eVldenclng any or all rlghts to any such water hereln
~~r~~~s the addre~ of 4020 DOVER STREET, WBEAT RIDGE (Street. City].
Colorado 80033 [Zip Codel ("Property Addre~");
COLORADo.single Family -FNMAlFIILMC UNIFORM INSTRUMENT
G -tiR(CO) ('il6O'Jl VMP MORTGAGE FORMS. (800):iZI.7731
~ C03006 (II/319M
Form 3006 1/9\
Ammded 5/9\
OIJlrlbullld by PormAlion Tect.wIo&leJ" Jill:, (100)9]1-3199
PaI"ln(iS
TOGETHER WITH all the: improvements now or he:reafte:r erc:de:d on the: prop::rty. and all c:ascmc:nts, appurtc:nances.
and tlxture:s now or he:re:afte:r a part of the: propc:rty. All re:placc:ments and additions shall also be covc:red by this Security
Instrume:nt. All of the: fore:golOg IS re:fe:rred-to in this Security lnstrument as the "Property."
BORROWER COVENANTS that Borrower IS lawfully seised of the estate hereby conveyed and has the fight to grant
and l.;onve:y the: Prope::rty and that the:: Propt:rty is unencumbe:re:d, e:x..:ept for encumbrance:s of re:..:ord. Borrower warrants and
will de::timd generally the: title: to the: Propdrty against all claims and demands, subject to any encumbram:e::s of re:cord.
THIS SECURITY INSTRUMENT combi""s uniform covenants for national use and non-uniform covenants with
limited variations by jurisdiction to constitute a uniform security instrument covering real property.
UNIFORM COVENANTS. Borrower and Lender covenant and agree as follows:
1. Payment of Principal and Interest; Prepayment and Late Charges. Borrower shall promptly pay when due the
principal of and interest on the debt evidenced by the Note and any prepayment and late charges due under the Note.
2. Funds for Taxes and Insurance. Subject to applicable law or to a written waiver by Lender. Borrower shall pay to
Lender on the day monthly payments are due under the Note. until the Note is paid in full. a sum ("Funds") for: (a) yearly
taxes and assessments which may attain priority over this Security Instrument as a lien on the Property; (b) yearly leasehold
payments or ground rents on the Property, if any; (c) yearly hazard or property insurance premiums; (d) yearly flood
insurance premiums, if any; (e) yearly mortgage insurance premiums, if any; and (f) any sums payable by Borrower to
Lender. in accordance with the provisions of paragraph 8, in lieu of the payment of mortgage insurance premiums. These
items are called "Escrow Items. . Lender may. at any time, collect and hold Funds in an amount not to exceed the maximum
amount a lender for a federally related mortgage loan may require for Borrower's escrow account under the federal Real
Estate Settlement Procedures Act of 1974 as amended from time to time, 12 U.S.C. Section 2601 et seq. ("RESPA"), unless
another law that applies to the Funds sets a lesser amount. If so, Lender may, at any time, collect and hold Funds in an
amount not to exceed the lesser amount. Lender may estimate the amount of Funds due on the basis of current data and
reasonable estimates of expenditures of future Escrow Items or otherwise in accordance with applicable law.
The Funds shall be held in an institution whose deposits are insured by a federal agency, instrumentality, or entity
(including Lender, if Lender is such an institution) or in any Federal Home Loan Bank. Lender shall apply the Funds to pay
the Escrow Items. Lender may not charge Borrower for holding and applying the Funds, annually analyzing the escrow
account, or verifying the Escrow Items, unless Lender pays Borrower interest on the Funds and applicable law permits
Lender to make such a charge. However, Lender may require Borrower to pay a one-time charge for an independent real
estate tax reporting service used by Lender in connection with this loan, unless applicable law provides otherwise. Unless an
agreement is made or applicable law requires interest to be paid, Lender shall not be required to pay Borrower any interest
or earnings on the Funds. Borrower and Lender may agree in writing, however, that interest shaII be paid on the Funds.
Lender shall give to Borrower, without charge, an annual accounting of the Funds. showing credits and debits to the Funds
and the purpose for which each debit to the Funds was made. The Funds are pledged as additional security for all sums
secured by this Security Instrument.
If the Funds held by Lender exceed the amounts permitted to be held by applicable law. Lender shall account to
Borrower for the excess Funds in accordance with the requirements of applicable law. If the amount of the Funds held by
Lender at any time is not sufficient to pay the Escrow Items when due. Lender may so notify Borrower in writing, and, in such
case Borrower shall pay to Lender the amount necessary to make up the deficiency. Borrower shall make up the deficiency in
no more than twelve monthly payments, at Lender's sole discretion.
Upon payment in full of all sums secured by this Security Instrument, Lender shall promptly refund to Borrower any
Funds held by Lender. If, under paragraph 21. Lender shall acquire or sell the Property, Lender. prior to the acquisition or
sale of the Property, shall apply any Funds held by Lender at the time of acquisition or sale as a credit against the sums
secured by this Security Instrument.
3. Application of Payments. Unless applicable law provides otherwise. all payments received by Lender under
paragraphs I and 2 shall be applied: first, to any prepayment charges due under the Note; second. to amounts payable under
paragraph 2; third, to interest due; fourth, to principal due; and last, to any late charges due under the Note.
4. Charges; Liens. Borrower shall pay all taxes. assessments. charges, fines and impositions attributable to the Property
which may attain priority over this Security Instrument, and leasehold payments or ground rents, if any. Borrower shall pay
these obligations in the manner provided in paragraph 2, or if not paid in that manner, Borrower shall pay them on time
directly to the person owed payment. Borrower shall promptly furnish to Lender all notices of amounts to be paid under this
paragraph. If Borrower makes these payments directly, Borrower shall promptly furnish to Lender receipts evidencing the
payments.
Borrower shall promptly discharge any lien which has priority over this Security Instrument unless Borrower: (a) agrees
in writing to the payment of the obligation secured by the lien in a manner acceptable to lender: (b) contests in good faith
the lien by, or defends against enforcement of the lien in. legal proceedings which in the lender's opinion operate to prevent
the enforcement of the lien; or (c) secures from the holder of the lien an agreement satisfaL:tory to Lender subordinating the
hen to this Se:curity Instrument. If Lende::r determines that any part of the Propt:rty is subje:ct to a lien which may attain
priority over this Se:curity In."itrument. Ltmder may give Borrower a notice identifying the:: lien. Borrower shall satisfy the lien
or take:: one or more of the actions set forth above within 10 days of the giving of notice.
.. .6KeeO) ,'1f1ll'll
~C03l)06 111/1Nfll
Form J006 1/91
p",e ~ ..r fl
S. Ha7.ard or Property Insurance. Borrowc:r shall kec:p the improvc:ments now existing or hereaftc:r erc:ctc:d on the
Propt:rty in.sure~ aga,inst lo.ss hy tire, hazar~s included within the tc:rm "c:xtc:mlc:d coverage" and any other hazards, including
floods or flooding, tor which Lc:rxJer rC:4ulre:s 1000mrance, This insurance: shall be maintained in the: amounts and for the
pc:riods that Lender re4ulrc:s. The in"iurancc: carrier providing the in.surance shall be chosen by Borrowc:r subjc:ct to Lender's
approval which shall not be unre:asonably withheld. If Borrower fails to maintain coverage descri~d above, lender may, at
Leooer's option, obtain covc:rage: to protect Lender's rights in the Property in accordance with paragraph 7.
All insuranco policios and ro""wals shall bo accoptablo to Londor and shalllllcludo a standard mortgago c1auso. Londor
shall haw tho right to hold tho policios and ro""wals. If Londor roquires. Borrowor shall promptly givo to Londor all recoipts
of paid premiums and renewal notices. In the event of loss, Borrower shall give prompt notice to the insurance carric:r and
Londor. Londor may mal<o proof of loss if not mado promptly by Borrower.
Unless Lender and Borrower otherwise agree in writing, insurance proceeds shall be applied to restoration or repair of
tho Proporty damagod, if tho rostoralion or ropair is oconomically foasible and Londer's socurity is not lossoned. If the
restoration or repair is not economically feasible or Lender's security would be lessened, the insurance proceeds shall be
appliod to tho sums socurod by this Socurity Instrument, whothor or not thon duo, with any oxcoss paid to Borrower. If
Borrowor abandons tho Proporty, or does not answer within 30 days a notico from Londor that tho insurance carrier has
offorod to sottlo a claim, thon Londor may collect the insuranco proceeds. Londer may use tho proceods to repair or restore
tho Proporty or to pay sums socurod by this Socurity Instrument, whether or not thon duo. Tho 30-day period will begin whon
the: notice is given.
Unloss Londer and Borrower otherwiso agree in writing, any application of proceeds to principal shall not extend or
postpone the duo date of the monthly payments referred to in paragraphs I and 2 or change the amount of the payments. If
under paragraph 21 the Property is acquired by Lender, Borrower's right to any insurance policies and proceeds resulting
from damage to the Property prior to the acquisition shall pass to Londer to tbe extent of the sums socured by this Socurity
Instrument immediately prior to the acquisition.
6, Occupancy, Preservation, Maintenance and Protection of the Property; Borrower's Loan Application; Leaseholds,
Borrower shall occupy, establish, and use the Property as Borrower's principal residence within sixty days after the execution
of this Security Instrument and shall continuo to occupy the Property as Borrower's principal residence for at least one year
after the date of occupancy, unless Londer otherwise agrees in writing, which consent shall not be unreasonably withheld, or
unless extenuating circumstances exist which are beyond Borrower's control. Borrower shall not destroy, damage or impair
the Property, allow the Property to deteriorate, or commit waste on the Property. Borrower shall be in default if any
forfeiture action or proceeding, whether civil or criminal, is begun that in Londer's good faith jndgment could result in
forfeiture of the Properly or otherwiso materially impair the lien created by this Security Instrument or Londer's socurity
intorest. Borrower may cure such a default and reinstate, as provided in paragraph 18, by causing the action or proceeding to
be dismissod with a ruling that, in Lender's good faith determination, precludes forfeiture of the Borrower's interest in the
Property or other material impairment of the lien created by this Security Instrument or Lender's security interest. Borrower
shall also be in default if Borrower, during the loan application process, gave materially false or inaccurate information or
statements to Londer (or failed to provide Londer with any material information) in connection with the loan evidencod by
the Note, including, but not limited to, represontations concerning Borrower's occupancy of the Property as a principal
residence. If this Security Instrument is on a teasehold, Borrower shall comply with all the provisions of the lease. If Borrower
acquires fee title to the Property, the leasehold and the fee title shall not merge unless Lender agrees to the merger in
writing.
7, Protection of Lender's Rights in the Property. If Borrower fails to perform the covenants and agreements contained
in this Security Instrument, or there is a legal proceoding that may significantly affect Lender's rights in the Property (such as
a proceeding in bankruptcy, probate, for condemnation or forfeiture or to enforce laws or regulations), then Lender may do
and pay for whatever is necessary to prolect the valuo of the Property and Lender's rights in the Property. Londer's actions
may include paying any sums securod by a lion which has priority ovor this Security Instrument, appearing in court, paying
roasonable attorneys' feos and ontering on the Property to make repairs. Although Lender may tako action undor this
paragraph 7, Lender d<>c:s not have to do so,
Any amounts disbursod by Londor under this paragraph 7 shall bocomo additional debt of Borrowor secured by this
Security Instrument. Unless Borrower and Lender agree to other terms of payment, these amounts shall bear interest from
the dato of disbursoment at the Note rale and shall bo payable. with intorost, upon notico from Lender to Borrower
reque:sti ng payment,
8. Mortgage Insurance. If Londer roquirod mortgage insurance as a condition of making the loan socurod by this
Security Instrument, Borrower shall pay the premiums required to maintain the mortgage insurance in effect. If. for any
reason, the mortgage insurance coverage required by Lender lapses or ceases to be in effect, Borrower shall pay the
premiums required to obtain coverage substantially equivalent to the mortgage insurance previously in effect, at a cost
substantially equivahmt to the cost to Borrower of the mortgage insurance pft~viously in effect, from an altc:mate mortgage
in"iurer approved by L~nder. If substantiaUy equivalent mortgage ll1Surance coverage is not available, Borrower shall pay to
Lender oach month a sum equal to one-twelfth of the yearly mortgago insuranco promium being paid by Borrower whon the
insurance covt!rage lapsed or ceased to be in effect. Lender will accept. use and retain these paym~nts as a loss reserve In
. .flR,(CO) (~60~l f'UnD 3006 1/91
~()300fl i11/,l/WII Pa,oJof6
lieu of mortgage insuranl.:e. Loss res~rve payments may no longc:r be: n:quirt:d. at the option of Lemh:r. if mortgage insurancc:
coverage (in the amount and for the pc:riod that Lc:ndc:r requires) provided by an insurc:r approvc:d by Lendcr again becomc:s
availablc and is obtainc:d. Borrower shall pay the: premiums required to maintain mortgage insurance in effect, or to provide a
loss rescrve, until the rc:quiremc:nt for mortgage insuranl.:e ends in accordance with any written agre~rnent between Borrower
and Londor or applicablo law.
9. Inspection. Londor or its agent may make reasonable entries upon and inspections of tho Property. Lender shall give
Borrowc:r notice at the time of or prior to an inspection specifying rc:asonable cause for the inspection.
10. Condemnation. The proceeds of any award or claim for damages. direct or consequential, in connection with any
condemnation or other taking of any part of the Property. or for conveyance in lieu of condemnation. are hereby assigned and
shall 00 paid to Lender.
In the event of a total taking of the Property. the proceeds shall 00 applied to the sums secured by this Security
Instrument. whether or not then due. with any excess paid to Borrower. In the event of a partial taking of the Property in
which the fair market value of the Property immediately before the taking is equal to or greater than the amount of the sums
secured by this Security Instrument immediately before the taking. unless Borrower and Lender otherwise agree in writing,
the sums secured by this Security Instrument shall be reduced by the amount of the proceeds multiplied by the following
fraction: (a) the total amount of the sums secured immediately before the taking, divided by (b) the fair market value of the
Property immediately before the taking. Any balance shall be paid to Borrower. In the event of a partial taking of the
Property in which the fair market value of the Property immediately before the taking is less than the amount of the sums
secured immediately before the taking, unless Borrower and Lender otherwise agree in writing or unless applicable law
otherwise provides, the proceeds shall 00 applied to the sums secured by this Security Instrument whether or not the sums are
then due.
If the Property is abandoned by Borrower. or if, after notice by Lender to Borrower that the condemnor offers to make
an award or settle a claim for damages. Borrower fails to respond to Lender within 30 days after the date the notice is given,
Lender is authorized to collect and apply the proceeds, at its option, either to restoration or repair of the Property or to the
sums secured by this Security Instrument, whether or not then due.
Unless Lender and Borrower otherwise agree in writing, any application of proceeds to principal shall not extend or
postpone the due date of the monthly payments referred to in paragraphs I and 2 or change the amount of such payments.
n. Borrower Not Released; Forbearance By Lender Not a Waiver . Extension of the time for payment or modification of
amortization of the sums secured by this Security Instrument granted by Lender to any successor in interest of Borrower shall
not operate to release the liability of the original Borrower or Borrower's successors in interest. Lender shall not be required
to commence proceedings against any successor in interest or refuse to extend time for payment or otherwise modify
amortization of the sums secured by this Security Instrument by reason of any demand made by the original Borrower or
Borrower's successors in interest. Any forooarance by Lender in exercising any right or remedy shall not be a waiver of or
preclude the exercise of any right or remedy.
12. Successors and Assigns Bound; Joint and Several LlabUlty; Co-signers. The covenants and agreements of this
Security Instrument shall bind and benefit the successors and assigns of Lender and Borrower, subject to the provisions of
paragraph 17. Borrower's covenants and agreements shall be joint and several. Any Borrower who co-signs this Security
Instrument but does not execute the Note: (a) is co-signing this Security Instrument only to mortgage, grant and convey that
Borrower's interest in the Property under the terms of this Security Instrument; (b) is not personally obligated to pay the
sums secured by this Security Instrument: and (c) agrees that Lender and any other Borrower may agree to extend, modify,
forbear or make any accommodations with regard to the terms of this Security Instrument or the Note without that
Borrower's consent.
13. Loan Charges. If the loan secured by this Security Instrument is subject to a law which sets maximum loan charges.
and that law is finally interpreted so that the interest or other loan charges collected or to 00 collected in connection with the
loan exceed the permitted limits, then: (a) any such loan charge shall be reduced by the amount necessary to reduce the
charge to the permitted limit: and (b) any sums already collected from Borrower which exceeded permitted limits will be
refunded to Borrower. Lender may choose to make this refund by reducing the principal owed under the Note or by making a
direct payment to Borrower. If a refund reduces principal. the reduction will be treated as a partial prepayment without any
prepayment charge under the Note.
14, Notices. Any notice to Borrower provided for in this Security Instrument shall be given by delivering it or by mailing
it by first class mail unless applicable law requires use of another method. The notice shall be directed to the Property
Address or any other address Borrower designates by notice to Lender. Any notice to Lender shall be given by first class mail
to Lendc:r's address stated herein or any other address Lender designates by notice to Borrower. Any notice provided for in
this Security Instrument shall be deemed to have been given to Borrower or Lender when given as provided in this paragraph.
IS. Governing Law; Severability. This Security Instrument shall 00 governed by federal law and the law of the
jurisdiction in which the Propdrty is located. (n the event that any provision or clause of trus Se(;urity Instrumc:nt or the Note
contlicts with applicable law, such conflict shall not affect other provisions of this Security Instrurnc:nt or the Note which can
be given effed without the conflicting provision. To this end the provisions of this Security Instrumc:nt and the Note are
declared to be sc:verable.
16. Borrower'sCopy. Borrower shall be given one conformed copy of the Note and of this Security Instrument.
~ .6R(CO) IIIMN)
(IlC031106 iIIIlIW.)
fo'unD 3006 1/91
P~Il" 4 .,f 1\
17. Tra~sfer of the. Prnperty or a Beneficial Interest in Borrower. I f all or any part of thd Property or any intdrdst in it is
sold or transterrdd _ (or It a bendi(.;lal '"terdst in Borrowdr is sold or transt~rr~d and Borrowdr is not a natural pdrson) without
L~ndt:r's pnor wrmdn (.;ons~nt. L~nddr may. at il<; option. rdquir~ immddiat_~ paymdnt in full of all sums secured by this
Sdl.:unty Instrument. How~vdr. this option shall not b~ ex~rclsdd by Lcmda if c:xtm.:ise is prohibitdd by federal law as of the
date of. thiS Secunty Instrument.
It Lc:nder exercises this option. Lender shall give Borrower notice of accderation. The notice shall provide a period of
not less than 30 days from thd date the notice is delivered or malted within which Borrower must pay all sums secured by this
Se..:unty Instrument. If Borrowdr fails to pay these sums prior to the expiration of this period, Lender may invoke any
remedies permitted by this Security Instrument without further notice or demand on Borrower.
18. Borrower's Right to Reinstate. If Borrower meets certain conditions, Borrower shall have the right to have
enforcement of this Security Instrument discontinued at any time prior to the ""rlier of: (a) 5 days (or such other period as
applicable law may specify for reinstatement) before sale of the Property pursuant to any power of sale contained in this
Secunty Instrument: or (b) entry of a judgment enforcing this Security Instrument. Those conditions are that Borrower: (a)
pays Lender all sums which then would be due under this Security Instrument and the Note as if no acceleration had
occurred: (b) cures any default of any other covenants or agreements: (c) pays all expenses incurred in enforcing this Security
(nstrument. including. but not limited to. reasonable attorneys' fees: and (d) takes such action as Lender may reasonably
re<juire to assure that the lien of this Security Instrument. Lender's rights in the Property and Borrower's obligation to pay
the sums secured by this Security Instrument shall continue unchanged. Upon reinstatement by Borrower, this Security
Instrument and the obligations secured hereby shall remain fully effective as if no acceleration had occurred. However, this
nght to reinstate shall not appl y in the case of acceleration under paragraph I7.
19. Sale of Note; Change of Loan Servicer. The Note or a partial interest in the Note (together with this Security
Instrument) may be sold one or more times without prior notice to Borrower. A sale may result in a change in the entity
(known as the "Loan Servicer") that collects monthly payments due under the Note and this Security Instrument. There also
may be one or more changes of the Loan Servicer unrelated to a sale of the Note. If there is a change of the Loan Servicer,
Borrower will be given written notice of the change in accordance with paragraph 14 above and applicable law. The notice
will state the name and address of the new Loan Servicer and the address to which payments should be made. The notice will
also contain any other information required by applicable law.
20. Hazardous Substances. Borrower shall not cause or permit the presence, use, disposal, storage, or release of any
Hazardous Substances on or in the Property. Borrower shall not do, nor allow anyone else to do, anything affecting the
Property that is in violation of any Environmental Law. The preceding two sentences shall not apply to the presence, use, or
storage on the Property of small quantities of Hazardous Substances that are generally recognized to be appropriate to
normal residential uses and to maintenance of the Property.
Borrower shall promptly give Lender written notice of any investigation. claim, demand, lawsuit or other action by any
governmental or regulatory agency or private party involving the Property and any Hazardous Substance or Environmental
Law of which Borrower has actual knowledge. If Borrower learns, or is notified by any governmental or regulatory authority,
that any removal or other remediation of any Hazardous Substance affecting the Property is necessary, Borrower shall
promptly take all necessary remedial actions in accordance with Environmental Law.
As used in this paragraph 20, "Hazardous Substances" are those substances defined as toxic or hazardous substances by
Environmental Law and the following substances: gasoline, kerosene, other flammable or toxic petroleum products, toxic
pesticides and herbicides, volatile solvents, materials containing asbestos or formaldehyde, and radioactive materials. As used
in this paragraph 20, "Environmental Law" means federal laws and laws of the jurisdiction where the Property is located that
relate to health, safety or environmental protection.
NON-UNIFORM COVENANTS. Borrower and Lender further covenant and agree as follows:
21. Acceleration; Remedies. Lender shall give notice to Borrower prior to acceleration following Borrower's hreach of
any covenant or agreement in this Security Instrument (hut not prior to acceleration under paragraph 17 unless applicahle
law provides otherwise). The notice shall specify: (a) the default; (b) the aelion required to cure the default; (c) a date, not
less than 30 days from the date the notice is given to Borrower, by which the default must be cured; and (d) that failure to
cure the default on or before the date specified in the notice may result in acceleration of the sums secured by this Security
Instrument and sale of the Property. The notice shall further inform Borrower of the right to reinstate after acceleration
and the right to assert in the foreclosure proceeding the non-existence of a default or any other defense of Borrower to
acceleration and sale. If the default is not cured on or before the date specified in the notice, Lender, at its option, may
re<juire immediate payment in full of all sums secured by this Security Instrument without further demand and may invoke
the power of sale and any other remedies permitted by applicable law. Lender shall be entitled to collect all expenses
incurred in pursuing the remedies provided in this paragraph 21, including, but not limited to, reasonable attorneys' fees
and cosl_ of tille evidence.
If Lender invokes the power of sale, Lender shall give written notice to Trustee of the occurrence of an event of default
and of Lender's election to cause the Property to be sold. Lender shaD mail a copy of the notice to Borrower as provided in
parallraph 14. Trustee shall record a copy of the notice in the county in which the Prope~ty is ~ocated. Tru_~ee shall p,:,blish
a notice of sale for the time and in the manner provided by applicable law and shall mad COpIes of the notice of sale m the
manner prescribed by applicable law to Borrower and to the other persons prescrihed by applicable law.
.. .6R(CO) (96091
~COJ006 (lllll9fH
Form 3006 1/91
P..~o 5 of I)
after the time required hyappllcable law, Trustee, without demand on Borrower,shall sell the Property at public auction to
the highest bidder for cash at the time and place and under the tenm designated in the notice of sale in one or more
parcels and in any order Trustee detenoines. Trustee may postpone sale of any parcel of the Property by public
announcement at the time and place of any previously scheduled sale. Lender or its designee may purchase the Property at
any sale.
Trustee shall deliver to the purchaser Trustee's certificate describing the Property and the time the purchaser wUl be
entitled to Trustee's deed. The recitals in the Trustee's deed shall be prima facie evidence of the truth of the statements
made therein. Trustee shall apply the proceeds of the sale in the following order: (a) to all expenses of the sale, including,
hut not limited to, reasonable Trustee's and attorneys' fees; (b) to all SWDS secured by this Security Instrwnent; and (c) any
excess to the person or persons legally entitled to It.
22. Release. Upon payment of all sums secured by this Security Instrument, Lender shall request that Trustee release
this Security Instrument and shall produce for Trustee, duly cancelled. all notes evidencing debts secured by this Security
Instrument. Trustee shall release this Security Instrument without further inquiry or liability. Borrower shall pay any
recordation costs and the statutory Trustee's fees.
23. Waiver of Homestead. Borrower waives all right of homestead exemption in the Property.
24. Riders to this Security Instrument. If one or more riders are executed by Borrower and recorded together with this
Security Instrument. the covenants and agreements of each such rider shall be incorporated into and shall amend and
supplement the covenants and agreements of this Security Instrument as if the rider(s) were a part of this Security
Instrument.
[Check applicable box(es)]
m Adjustable Rate Rider
D Graduated Payment Rider
D Balloon Rider
D VA Rider
D Condominium Rider
Dp~~dUuItD~eIDpment
D Rider Rate Improvement Rider
D Other(s) [specify]
I!!l 1-4 Family Rider
D Biweekly Payment Rider
D Second Home Rider
BY SIGNING BELOW, Borrower accepts and agrees to the terms and covenants contained
and in any rider(s) executed by Borrower and recorded with it.
Witnesses:
in this Security Instrument
Jay C...rOD Luna
40Z0 Dover Street
Wheat Ridge, CO 80033
(Seal)
-Borrower
DiaDa WilaoD Lund
40Z0 Doyer Street
Wheat R1dge, CO 80033
(Seal)
-Borrower
(Seal)
-Borrower
(Seal)
-Borrower
ST ATE OF COLORADO,
Jefferson
County 55:
The foregoing instrument was acknowledged before me this ZND
1998 . by Jay Ca.eroD LUDd and DiaDa WilaoD LUDd
day of MAY
Witness my hand and official seal.
My Commission Expires: MARCH 30, Z002
Stacy B. Shaffer
4350 Wadsworth Blvd.
Whest Ridge, Colorado 80033
Notary Public
~-tlR(CO),'''''\
C03006 (lIIJ/96j Puol.6oflS
Borrower'. .811ing addre.. i.: 4020 Dover street, Wheat Ridge, CO
Form 3006 1/9t
80033
May 26, 1998
4020 Dover
~
Plans have been reviewed and the following deficiencies were noted:
1. Light fixtures in second and third bedroom closets must meet NEC locations.
2. Bedroom windows to meet egress requirements.
3. Fire separation to be maintained between house and garage with 20 minute door and
5/8 type X drywall.
Plans must be stamped "approved" prior to issuance of building permit.
Said Plans have corrections noted on them and may be issued for construction.
PERMIT TRACKING FORM
ADDRESS -40;;JO Dou.--u- 0.Jr-et"l ~
DATE SUBMITTED S- -lZ -C!J PERMIT NUMBER l 1l0'3
1YPE OF PERMIT Adt-t-'On -+ iZfl h(jUCJ.-l0iJ
-tV ~(c)..-enCZ
CONTRACTOR PHONE
OWNER -.:Joy C. L / U nd PHONE <J 3.).. - J-! nO /
1YPEOFREQUEST(1('Jcfth'fT'n =I!?-In/J/)(; I/oV') --!r) '!:V/,"'5-!/10J /Zr5Id~/7C-e.-
~1EJ!'I~lT~D (..,.. ~ ,q 1.. DATE AND REASON FOR PERMIT DENIAL
REQUIRED CONDITIONS MET PRIOR TO PERMIT APPLICATION 7 YES NO
N/A
CONDITIONS OF APPROVAL
DATE IN DATE OUT
;/ BUILDING DEPARTMENT ~-- 22 -1g- S /,M/~
, '"
J4 ENGINEERING DEPARTMENT <0 - rl. -Q9..:> ~,. a. -q~) G-\<
A PLANNING DEPARTMENT C; . ~l -Cjp' <5/zfi!/qe, ~
0 FIRE DEPARTMENT
0 CI1Y ARBORIST
0 POLICE DEPARTMENT
0 SEWER DISTRICT
0 WATER DISTRICT
0 OTHER
CERTIFICATE OF OCCUPANCY I CERTIFICATE OF COMPLETION
DATE IN DATE OUT
0 BUILDING DEPARTMENT
0 ENGINEERING DEPARTMENT
0 PLANNING DEPARTMENT
o FIRE DEPARTMENT
DATE CERTIFICATE OF OCCUPANCY /lCElTlF~TE Ol"COMI'LEnON I55UED 8 'd-.B -0 \
TEMPORARY CERTIFICATE OF OCCUPANCY
DATE IN
DATE OUT
o 6UILDING DEPARTMENT
o ENGINEERING DEPARTMENT
o PLANNING DEPARTMENT
o FIRE DEPARTMENT
PLANNING ESc;ROW CONDITIONS
AMOUNT
ENGINEERING ESCROW CONDITIONS
. DATE TEMPORARY CERTIFICATE OF OCCUPANCY ISSUED
AMOUNT
DATE EXPIRED