HomeMy WebLinkAbout4160 Brentwood StreetFrom: no-reolvCalci.wheatridae.co.us
To: CommDev Permits
Subject: Online Form Submittal: PERMIT APPLICATION General
Date: Monday, March 14, 2022 9:08:25 AM
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PERMIT APPLICATION General
This application is exclusively for Scopes of Work that do not already have a
specific form.
YOU MUST ATTACH AN ELECTRONIC PAYMENT FORM IN ORDER FOR THE
PERMIT TO BE PROCESSED.
THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN
WORK UNTIL PERMIT HAS BEEN ISSUED.
PROPERTY INFORMATION
Is the property Residential
Residential or
Commercial?
Property Address 4160 Brentwood Street, Wheat Ridge, CO 80033
Property Owner Name Craig & Jaime Wilson
Property Owner Phone 317-331-4240
Number (enter WITH
dashes, eg 303-123-
4567)
Property Owner Email permits@applewoodfixit.com
Address
Attach City of Wheat 03 14 22 Wheat Ridge CC Payment Form Ddf
Ridge Electronic
Payment Form - "DO
NOT ATTACH A
PICTURE OF A
CREDIT CARD"
CONTACT INFORMATION
Submitting General Applewood Plumbing, Heating & Electric
Contractor or Architect
Contractor's License 18236
Number (This is a 5 or
6 digit number for the
City of Wheat Ridge)
Contract Phone 303-458-5988
Number (enter WITH
dashes, eg 303-123-
4567)
Contact Email Address permits@applewoodfixit.com
Retype Contact Email permits@applewoodfixit.com
Address
Check the appropriate Plumbing
boxes if the following
work is involved in the
project.
Plumbing Contractor Applewood Plumbing, Heating & Electric
Name
Plumbing Contractor 18236
License Number (This
is a 5 or 6 digit number
for the City of Wheat
Ridge)
Are there any
No
ADDITIONAL Sub
Contractors associated
with this project?
DESCRIPTION OF WORK
Detailed Scope of
Replace and repair four leaks in the gas line in the crawl space.
Work - Provide a
Line was red tagged by Xcel.
detailed description of
work including
mechanical, electrical,
plumbing work
occurring,
adding/removing walls,
etc.
Square footage of
35'
scope of work
Location of work
Crawl Space
(backyard, on roof, etc)
Project Value (contract
value or cost of ALL
materials and labor)
Upload Engineer letter
Upload Asbestos
Report if triggler level is
met per CDPHE
regulation.
Upload Drawings
5326.00
Field not completed.
Field not completed.
03.14.22-4160 Brentwood Street, Wheat Ridae (W0813961).odf
Upload Additional Field not completed.
Drawings
Upload Additional Field not completed.
Drawings
Upload Additional Field not completed.
Drawings
SIGNATURE OF UNDERSTANDING AND AGREEMENT
I assume full Yes
responsibility for
compliance with
applicable City of
Wheat Ridge codes
and ordinances for
work under any permit
issued based on this
application.
I understand that work Yes
may not begin on this
property until a permit
has been issued and
posted on the property.
I certify that I have Yes
been authorized by the
legal owner of the
property to submit this
application and to
perform the work
described above.
I attest that everything Yes
stated in this
application is true and
correct and that
falsifying information in
this application is an
act of fraud and may
be punishable by fine,
imprisonment, or both.
Person Applying for Tracey L. Johnson
Pe rm it
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414 , — INSPECTION kECORD Occupancy/Type
INSPECTION ONLINE FORM: http://www.ci.wheatridge.co.us/inspection
INSPECTION REQUEST LINE: (303) 234-5933
Cancellations must be submitted via the online form before 8 a.m. the day of the inspection
Inspections will not be performed unless this card is posted on the project site.
**Request an inspection before 11:59 p.m. (midnight) to receive an inspection the following business day.**
Inspector Must Sign ALL Spaces pertinent to this project
Foundation Inspections Date Inspector
Initials Comments
Pier
Concrete Encased Ground (CEG)
Foundation / P.E. Letter
Do Not Pour Concrete Prior To A proval Of The Above Inspections
Underground/Slab Inspections Date Inspector
Initials Comments
Electrical
Sewer Service
Plumbing
Do Not Cover Undernrnunrl nr Rnlf%wiln_Cl�k
R ugh Inspections
- ----
Date
Inspector
Initials
- - ,— 1%o i- i -vol %ii irye Hpove inspections
— -
Comments
Bathing
Mid -Roof
Lath /Wall Tie
Rough Electric'
Rough Plumbing/Gas Line
Rough Mechanical
Rough Framing
I
l
Rough Grading
Insulation
---�
Drywall Screw / Nail
ctions
Date
Inspector
Initials
-
Comments
&Parking /Planning Dept.
gFloodplain
-1
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.
age / Public Works Dept.
spection (if applicable)
Fire Inspection / Fire Protection Dist.
Final Electrical
Final Plumbing
—
Final Mechanical
Roof
Final Window/Doors
Final Building
NOTE. All items must be completed and approved by Planning, Public Works, Fire and Building before a Certificate
of Occupancy is issued. Approval of the Final Building inspection does not constitute authorization of occupancy.
'For low voltage permits - Please he curs that mi inh incnonC- .,.............i..a
- - - --...r. —.0L1 11,LC31w cic1u iLdi iow Voltage
y e Building Division.
Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued
Protect This Card From The Weather
A ® City of Wheat Ridge
Residential Roofing PERMIT - 201707162
PERMIT NO: 201707162 ISSUED: 09/12/2017
JOB ADDRESS: 4160 Brentwood ST EXPIRES: 09/12/2018
JOB DESCRIPTION: Residential Re -roof to install OC duration asphalt shingles - 15 sq Pitch
= 5/12
*** CONTACTS ***
OWNER (303)431-0870
SEURER INEZ M
SUB (720)284-8831
Brent Roper
160146 BLLR dba
Ropa Roofing
*** 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:
8,980.00
FEES
Total Valuation
0.00
Use Tax
188.58
Permit Fee
188.45
** TOTAL **
377.03
*** COMMENTS ***
*** CONDITIONS ***
Effective December 1, 2014, asphalt shingle installations require an approved midroof
inspection, conducted when 25-75 percent of the roof covering is installed, prior to final
approval. Installation of roof sheathing (new or overlay) is required on the entire roof
when spaced or board sheathing with ANY gap exceeding one half inch exists. Sheathing and
mid -roofs may be called in at the same time, one hundred percent of the sheathing must be
complete and 25-75 percent of the mid -roof may be complete. Asphalt shingles are required
to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield
is required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave
and secured in place is required to be provided for all roof inspections. Roof ventilation
is required to comply with applicable codes and/or manufacturer installation instructions,
whichever is more stringent. In order to pass a final inspection of elastomeric or similar
type roof coverings, a letter of inspection and approval from the manufacturer technical
representative stating that "the application of the roof at (project address) has been
applied in accordance with the installation instruction for (roof material brand name)
roof covering" is required to be on site at the time of final inspection.
Midroof & Final Roof inspections for ROOFS OVER 6/12 PITCH: 3rd party inspection will be
required, the 3rd party inspection report AND THE ORIGINAL PERMIT CARD needs to be dropped
off to the Permit Desk at the City of Wheat Ridge. The report MUST BE SIGNED by the
Homeowner.
City of Wheat Ridge
Residential Roofing PERMIT - 201707162
PERMIT NO: 201707162 ISSUED: 09/12/2017
JOB ADDRESS: 4160 Brentwood ST EXPIRES: 09/12/2018
JOB DESCRIPTION: Residential Re -roof to install OC duration asphalt shingles - 15 sq Pitch
= 5/12
I, by�my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications,
appl&cable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorizes
by thtie
l o r of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with
this_p he atteqst that I am legally authorized to include all entities named within this document as parties to the work to be
perfoa t 11' Wl rk to b ;performed is disclosed in this document and/or its' accompanying approved plans and specifications.
Signature�pf OM NER-Jor CONTRACTOR (Circle one) Date
1% This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is
`spbjec,t to the compliance with those cuments, and all applicable statutes, ordinances, regulations, policies and procedures.
2. Thispermit shall expire 365 days_ aft the date of issuance regardless of activity. Requests for extension must be made in writing and
received prior to the date of expiration. An extension of no more than 180. days made be granted at the discretion of the Chief Building
Official and may be subject to a fee equal to one-half of the original permit fee.
3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard
requirements, fees and procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of
the Chief Building Official and is not guaranteed.
4. No work of any manner shall be performed that shall results in a changeof the natural flow of water without prior and specific approval.
5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required
inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services
Division.
6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any
applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection.
Signature of Chief Building Official '- Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
(0) RopaRoafing
ADDENDUM
Owner(s);
!9s McIntyre SI, Suile 303, Gulden, t:n 80101
Office: 720-475.1065
www,AopaRoofine.com
General LiabilityInsurer: Colony Specialty, NAIC:39993
Colorado Insurance Professionals, Inc. 13031755-9600
Agreement Date,
Address: H flyPAQCn� �1! Addendum Date:
ttp� LQi cc ,3 l Addendum Number:_
Roth parties hereby agree that this addendum is part of the Atreement between the parties The original 4reemient date is indicated ahuvP tnr reterencP.
GENERAL: ( (af�}1 �a r j 'mac C t�2 tLe-+tn
r^ 5 j
Owners) initials:
MATERIAL SELECTION
Shingle Brand: &Yp-,-5 C!^
ley
Shingle Type: d L� ey-2 C\
Shingle Color, L _
Owner(s) Initials;
UPGRADES
Description
Owner(s) initials:
CONTRACT AMOUNT
TataI Am4unr of Claim: $4Z
Total Amount ofUpgrades(AciditionalWork $
Less Credits for Work Nat Performed $
Contract Amount Total
'PLUSSUPPLEMFNf5AND ADDITIONALMON IES APPROVED BY
INSURANCE COMPANY
Drip Edge Color:
Gutter Size;tsi
Gutter Color;
Price Unit Total
Total Upgrades $_
PAYMENT TERMS
Deposit $ IiDue ('
Payment $ Due
Payment $ -L---T—
jibe
`BALANCE TO BE ALL SU PP LEM f N TS AND ADDITIONAL
M ONn- S APPI10VED BY I NSURANC E COMPANY
Property Owner's Signature nopaHaollag Reprrsent;i irc Signature
::gyp a.. /9
Print Nnme Print Name
(a) Ftopaftofing
AGRF.PM F;NT
PHONE:
INSURAMCF CO:
CLAIM #:
fins McIntyre SL Suite 363, Goftlen, CO 130401
Office: ;20-475-1065
www.aooaRoofine.cnm
General Liability Insufer: CCIOO 5pedalty, NAIC:39993
Cnloodo Insurance Professionars, inc. (M3) 755-8500
DATIC... q'i 6 1I —3
SCOPE: Shim; les removed: sq. Replaced: sq.
Type;
Pipe huotN: icefWater shield: _Q. Hip Ridge Cap „ fl.
Starter Shingles: R. 1]rip Ldgc tt. Coior:
Vent type: No.: _
Chimney Flashing: _ Step FIashing:
Other:
General: Both Parties agree to cooperate in good faith clybrts as follows. (1) to file a property damage claire
with the owner's insurance company upon executing this agreement, if damage is lirund. (2) to share all
information related to the insurance adjusters meeting anti naakc every atlempl to attend the adjusters meeting
together. (3) To provide each other with alt claims reports and other infonnation related to this claim.
RopaItoofrng will prepare the file for pmductil,)n and acquire all permits and other documents necessary to
comply with local requirements, As consideration flit the work provided by RepafRoofing, the owner hereby
agrees to (appoint RopaRooting as their exclusive c:ontractar.
If the claim is approved: RopaRoofng agrees to complete all work outlined in the owner's insurance clailriN
report, including all supplements and additional items agreed to by the owner's insurance company.
If the claim is denied: If the inspection is deniedt then this agreement is Null and Void. The owner is not
respansible for any payments to RupaRoofnts.
Payments: The parties agree that ltopaRooiing will he entitled to all insurance proceeds related to all claims
subject to this ngrectnem, and all other monies for upgrades or additional work that is appmved in writing by
the owner on [he addendum to this agreement. The owner understands that they al%c fully responsible fur their
insuranue Jeductiblrs, as stated by the Colorado Law 6-22-105. Waiver of insurance deductible prohibited.
Payments: Owner hereby releases their insurance uornpany to provide RupaRoofing with informatiur related
to this claim and hirthcrmnre grants permission for their insurance company to ncgotiate and wtflc all claims on
behalf orf the owners with third party adjusters, if necessary.
Owner's Rights: 4hould the owner decide to cancel this agreement, it must be done within 72 hOLITS of tlae
date signed. This ntay he dome via mail, dealt. or hand delivered letter — stating that they ,.wish to terminate this
agreement.
Scope: To be defined by the Ownet's insurance summary plus any additional upgrades, which they choose;
and shall be attached along with the addendum to this agreement.
THF ROOFING CONTRACTOR SHAI.i, HOLD IN TRUST ANY PAYMENT FROM THF.
PROPERTY OWNER UNTIL THE RCIOFTNC: CONTRACTOR HAS DF,T,iVERL D MATE,RIAI,S TO
THE SITE TO Wi-IICII THE WORK IS TO FIT: PERFORMED OR HAS Ir><MFORMED A MAJORiTY
OF THE ROOFING WORK ON THF. RF.SIDENTIAL PROPERTY,
Accepted by Property Owner on: Date Ily: X �
Sales Person; Date. jam f Jay: �C _
*THIS AGREEMENT 15 NULL AND VOID If INSPECTION IS DENIED
Dane Lovett 70 � 7 o/ I U
From:
Sent:
To:
Subject:
Follow Up Flag:
Flag Status:
no-reply@ci.wheatridge.co.us�;
Thursday, September 7, 2017 12:16 PM
CommDev Permits
Online Form Submittal: Residential Roofing Permit Application
Follow up
Completed
Residential Roofing Permit Application
This application is exclusively for new permits for residential roofs and for licensed
contractors only. This type of permit is ONLY being processed online --do not come
to City Hall to submit an application in person. Permits are processed and issued in
the order they are received and due to the volume of requests, time to process
varies and is subject to change. YOU WILL BE CONTACTED WHEN YOUR
PERMIT IS READY FOR PICK-UP AND WILL BE GIVEN A SPECIFIC DATE
AND TIME WINDOW TO COMPLETE THE TRANSACTION. You will be notified if
your contractor's license or insurance has expired, and you may update those
documents at the time you are issued your permit.
For all other requests:
Homeowners wishing to obtain a roofing permit must apply for the permit in person
at City Hall. Revisions to existing permits (for example, to add redecking) must be
completed in person at City Hall. All other non -roofing permits must be completed in
person at City Hall. The Building Division will be open from 7:30-10:30 a.m.,
Monday through Friday to process these types of requests.
THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN
REROOFING UNTIL PERMIT HAS BEEN ISSUED.
Is this application for a Yes
residential roof?
How many dwelling units Single Family Home
are on the property?
PROPERTY INFORMATION
Property Address 4160 Brentwood St
Property Owner Name Inez Seurer
Property Owner Phone 303-431-0870
Number (enter WITH
dashes, eg 303-123-4567)
37
Z
C
L�
Property Owner Email
Address
Do you have a signed
contract to reroof this
property?
Applications cannot be
submitted without an
executed contract
attached below.
Attach Copy of Executed
Contract
bunnie25@comcast.net
Yes
Seurer, Inez - Agreement.pdf
CONTRACTOR INFORMATION
Contractor Business Ropa Roofing
Name
Contractor's License
Number (This is a 5 or 6
digit number for the City
of Wheat Ridge)
Contractor Phone
Number (enter WITH
dashes, eg 303-123-4567)
Contractor Address
(Primary address of your
business)
160146
720-284-8831
795 McIntyre St., Golden, CO 80401
Contractor Email Address roparoofing@gmail.com
Retype Contractor Email roparoofing@gmail.com
Address
DESCRIPTION OF WORK
TOTAL SQUARES of 15
the entire scope of work:
Project Value (contract 8980):
value or cost of ALL _
materials and labor)
Are you re -decking the No
roof?
38
Does the scope of the No� t
project include a flat roof
(less than 2:12 pitch)?
Does the scope of the
project include a pitched
roof (2:12 or greater
pitch)?
Provide any additional house
detail here on the
description of work. (Is
this for a house or
garage? Etc)
SIGNATURE OF UNDERSTANDING AND AGREEMENT
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.
I understand that this
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
may not begin on this
property until a permit
has been issued and
posted on the property.
I certify that I have been
authorized by the legal
owner of the property to
submit this application
and to perform the work
described above.
I attest that everything
stated in this application
is true and correct and
that falsifying
Yes
Yes
Yes
Yes
Yes
39
information in this
application is an act of
fraud and may be
punishable by fine,
imprisonment, or both.
Name of Applicant Brent Roper
Email not displaying correctly? View it in your browser.
40
information in this
application is an act of
fraud and may be
punishable by fine,
imprisonment, or both.
Name of Applicant Brent Roper
Email not displaying correctly? View it in your browser.
40
City of Wheat Ridge
Residential Miscella PERMIT - 201707782
PERMIT NO: 201707782 ISSUED: 09/28/2017
JOB ADDRESS: 4160 Brentwood ST
JOB DESCRIPTION:XPIES:Residential Siding replacement partialEreplacement off9gar8gage8and house
12sq(7sq house and 5sq garage)
*** CONTACTS ***
OWNER (303)431-0870 SEURER INEZ M
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned
SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: UA / Unassigned
0 /
*** FEE SUMMARY ***
ESTIMATED PROJECT VALUATION: 4,975.00
Total Valuation FEES
0.00
Use Tax
Permit Fee 104.48
TOTAL 125.05-
** ** 229.53
*** COMMENTS ***
*** CONDITIONS ***
Work shall comply with 2012 IRC & 2014 NEC. Per IRC Sec. R314, smoke detectors are required
to be installed in every sleeping room, in hallways outside of sleeping rooms, and on
level of the structure. every
1, byy myy signature, do hereby ttest that the work to be performed shall comply with all accom an ingg approved
applicabl building codes, and 11 applicable mu icipal codes, policies and procedures, and thatt I am thegal ownernor have been authorized
by the le al owner of t rope and am aut ri ed to obtain this permit and perform the work described and approved in conjunction with
this�pperm . I her a es that I leggally a h ized to include all entities named within this document as parties to the work to be
pertorme and rk to be erlormed s isclosed in this document and/or its' accompanying approved plans and specifications.
o_
Si nature of OWNER o ON CTOR (Circle ne) Date
I. is perm t was issued based on the information pro ided in the permit application and accompanying plans and specifications and is
s ect to he compliance with those documents, an all applicable statutes, ordinances, regulations, policies and procedures.
2. Thi it shall expire 365 days after the da *ssuance regardless of activity. Requests for extension must be made in writing and
received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building
Official and may be subject to a fee equal to one-half of the original ermit fee,
3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard
requirements, fees and procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of
the Chief Building Official and is not guaranteed.
4. No work of 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
Divn.ns and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services
6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any
applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection.
01*"�
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR
INSPECTION THE FOLLOWING BUSINESS DAY.
City of
RWh6at
TgeMMUNITY DEVELOPMENT
Building & Inspection Services Division
7500 W. 291h Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933
Email: permits(Dcimheatridge.co.us
FOR OFFICE USE ONLY
Date: q
Plan/Permit # � % J, `� —7
Plan Review Fee:
Building Permit Application
*** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. ***
Property Address: I I by ��'� �c'` 3t
Property Owner (please print): I ✓)t Z-. S1eV C-e/V- Phone: -5 G 3 • q 3 ( OS -70
Property Owner Email: �2V''1V-�tf' 2_ ^
� ) (_�)' C "VV-\CVlt�T_
Mailing Address: (if different than property address)
Address:
City, State, Zi
Architect/Engineer:
Architect/Engineer E-mail:
Contractor:
Contractors City License #:
Contractor E-mail Address: Vop,-/\ yo
Sub Contractors:
Electrical:
W.R. City License #
Other City Licensed Sub:
City License #
Plumbing:
W.R. City License #
Phone:
Phone: 1, `_y • z cc) C>5 l
Other City Licensed Sub:
City License #
Mechanical:
W.R. City License #
Complete all information on BOTH sides of this form
❑ COMMERCIAL )Y-I\RESIDENTIAL
Description of work: (Check all that apply)
❑ NEW COMMERCIAL STRUCTURE ❑ ELECTRICAL SERVICE UPGRADE
❑ NEW RESIDENTIAL STRUCTURE ❑ COMMERCIAL ROOFING
❑ COMMERCIAL ADDITION ❑ RESIDENTIAL ROOFING
❑ RESDENTIAL ADDITION ❑ WINDOW REPLACEMENT
❑ COMMERCIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.)
❑ RESIDENTIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.)
❑ MECHANICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT
❑ PLUMBING SYSTEM/APPLIANCE REPAIR or REPLACMENT
_ ❑E-LECTRICAL SYSTEM/A PLIANCE,REP IR or REP ACEMENT
OTHER(Describe) �ICA1�%V1VN�� y6VAA � �!%
(For ALL projects, please provide a detailed description of work to be performed, including current use of areas,
proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and
amount of materials to be used, etc.)
Sq. Ft.ILF
Amps
Btu's
Squares
p,
Gallons
Other
Project Value: (Contract value or the cost of all materials and labor included in the entire project)
I —r— 6 b
OWNEWCONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or
regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are
accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance
with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner
or have been authorized by the legal owner of the property to perforin the described work and am also authorized by the legal owner of any
entity included on this application to list that entity on this application. I, the applicant for this building permit application, warrant the
truthfulness of the information provided on the application.
CIRCLE ONE: (OWNER) (CONTRACTOR) r (AUT)HORIZED REPRESENTAT ) of (OWNER) (CONTRACTOR)
Signature (first and last name): C� DATE:
l-7
DEPARTMENT USE ONLY
ZONING COMMMENTS: OCCUPANCY CLASSIFICATION:
Reviewer:
BUILDING DEPARTMENT COMMENTS:
Reviewer:
Building Division Valuation: $
City of Wheat Ridge
Residential Roofing PERMIT - 201707162
PERMIT NO: 201707162 ISSUED: 09/12/2017
JOB ADDRESS: 4160 Brentwood ST EXPIRES: 09/12/2018
JOB.DESCRIPTION: Residential Re -roof to install OC duration asphalt shingles - 15 sq Pitch
= 5/12
***Revision add redecking 15sq****
*** CONTACTS ***
OWNER (303)431-0870 SEURER INEZ M
SUB (720)284-8831 Brent Roper 160146 BLLR dba Ropa Roofing
*** 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: 11,470.00
FEES
Total Valuation 0.00
Use Tax 240.87
Permit Fee 236.00
** TOTAL ** 476.87
*** COMMENTS ***
*** CONDITIONS ***
Effective December 1, 2014, asphalt shingle installations require an approved midroof
inspection, conducted when 25-75 percent of the roof covering is installed, prior to final
approval. Installation of roof sheathing (new or overlay) is required on the entire roof
when spaced or board sheathing with ANY gap exceeding one half inch exists. Sheathing and
mid -roofs may be called in at the same time, one hundred percent of the sheathing must be
complete and 25-75 percent of the mid -roof may be complete. Asphalt shingles are required
to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield
is required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave
and secured in place.is required to be provided for all roof inspections. Roof ventilation
is required to comply with applicable codes and/or manufacturer installation instructions,
whichever is more stringent. In order to pass a final inspection of elastomeric or similar
type roof coverings, a letter of inspection and approval from the manufacturer technical
representative stating that "the application of the roof at (project address) has been
applied in accordance with the installation instruction for (roof material brand name)
roof covering" is required to be on site at the time of final inspection.
Midroof & Final Roof inspections for ROOFS OVER 6/12 PITCH: 3rd party inspection will be
required, the 3rd party inspection report AND THE ORIGINAL PERMIT CARD needs to be dropped
off to the Permit Desk at the City of Wheat Ridge. The report MUST BE SIGNED by the
Homeowner.
City of Wheat Ridge
Residential Roofing PERMIT - 201707162
PERMIT N0: 201707162 ISSUED: 09/12/2017
JOB ADDRESS: 4160 Brentwood ST EXPIRES: 09/12/2018
JOB DESCRIPTION: Residential Re -roof to install OC duration asphalt shingles - 15 sq Pitch
= 5/12
***Revision add redecking 15sq****
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 t1�e legal owner or have been authorized
by the legal ow er of the property and am auth sized to obtain this permit and perform the work described and approved in conjunction with
this ermrt. I fu her atte that I am legally au prized to include all entities named within this document as parties to the work to be
performed and t at all vy rk to be performed disclosed in this docume end/or its accompanying approved plans and specifications.
Signature tif O R or `CONT-RA,TOR (CircleYided
e) Date
1. This permit wa issued based on the information fir, in the permit application and accompanying plans and specifications and is
subject to the ompliance with those documents`,
—and all applicable statutes, ordinances, regulations, policies and procedures.
2. This, permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and
received prior to the date of expiration. An extension of no more than 180.days made be granted at the discretion of the Chief Building
Official and may be subject to a fee equal to one-half of the original permit fee.
3. If this pen -nit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard
requirements, fees and procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of
the Chief Building Official and is not guaranteed.
4. No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval.
5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required
inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services
Division. ,-- --.'
6. The issuance o granting o it sh lb be construed to be a permit for or an approval of, an violation of any provision of any
applicable- woman r t n of this jurisdiction. Approval of work is subject to field inspection.
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
City of
�Wheatj�idge
MUNITY DEVELOPMENT
Building & Inspection Services Division
7500 W. 291h Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933
Email: permits(a)ci.wheatridge.co.us
FOR OFFICE USE ONLY
Date: // 7
Add to Permit #
cA y —7 671 z
Building Permit Revision/Amendment Application
*** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. ***
Property Address:
Property Owner (please print): i ✓ tz- S2�jl uec v Phone:
Property Owner Email: ✓V 11 Yl'l C1 ZV) P
Mailing Address: (if different than property address)
Address
City, State, Zip:
�ZoUf-I"
Contact Person: �Z7y�
Contractor: F0i'
�1 ��(} �el
UV---
If
LQ
Phone: Iz ' `S T>17
1ZO
Contractors City License #: i bn r �J Phone: �
Contractor E-mail Address: roPA Y-oc ► (!�j PL4vvto I
Please Note: Additional valuation must include all general and subcontracted work to be performed
related to the revisions and/or amendments declared in the description of work and which were not
included in the original permit valuation.
If revisions or amendments increase the original valuation, additional fees will be due at the time of
approval. Depending on the scope of work, additional plan review fees may be due upon approval
($60.00 an hour — 2 hour minimum).
Description of revised/amended work:
AJA 1. (e- d-edz--
Sq. Ft./LF
Amps
Btu's
Gallons
Squares � � Other
Additional Project Value: (Must include all general and subcontracted work to be performed related to revisions/amendments described above)
$
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 perfonm the described work and am also authorized by the legal owner of any
entity included on this application to list that entity on this applicati _
CIRCLE ONE: (OWNER) (CONTRACTOR) o (AUTHORIZ REPR `E ATIV f �iOWNER) (CONTRACTOR)
PRINT NAME: V K V Ir SIGNATURE: DATE: i 7t " 1
t DEPARTMEN :USE ONLY
ZONING COMMMENTS: OCCUPANCY CLASSIFICATION:
Reviewer.
BUILDING DEPARTMENT COMMENTS:
Reviewer:
PUBLIC WORKS COMMENTS:
Reviewer:
PROOF OF SUBMISSION FORMS
Fire Department ❑ Received ❑ Not Required
Water District ❑ Received ❑ Not Required
Sanitation District ❑ Received ❑ Not Required Building Division Valuation: $
, ► .r City of Wheat Ridge
Residential Roofing PERMIT - 201704587
PERMIT NO: 201704587 ISSUED: 07/21/2017
JOB ADDRESS: 4160 Brentwood ST EXPIRES: 07/21/2018
JOB DESCRIPTION: Residential Re -roof to install GAF Timberline HD asphalt shingles with 24
sq.
*** CONTACTS ***
OWNER (303)431-0870 SEURER INEZ M
SUB (720)276-8615 Denis Koval 150246 Global Construction 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: 6,600.00
FEES
Total Valuation 0.00
Use Tax 138.60".'
Permit Fee 156.75
** TOTAL ** 295.35
*** COMMENTS ***
*** CONDITIONS ***
Effective December 1, 2014, asphalt shingle installations require an approved midroof
inspection, conducted when 25-75 percent of the roof covering is installed, prior to final
approval. Installation of roof sheathing (new or overlay) requires an approved inspection
prior to installation of ANY roof coverings and is require on the entire roof when spaced
or board sheathing with ANY gap exceeding one half inch exists. Asphalt shingles are
required to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and
water shield is required. Eave and rake metal is required. A ladder extending 3 feet above
the roof eave and secured in place is required to be provided for all roof inspections.
Roof ventilation is required to comply with applicable codes and/or manufacturer
installation instructions, whichever is more stringent. In order to pass a final inspection
of elastomeric or similar type roof coverings, a letter of inspection and approval from the
manufacturer technical representative stating that "the application of the roof at (project
address) has been applied in accordance with the installation instruction for (roof
material brand name) roof covering" is required to be on site at the time of final
inspection.
Roof inspections for ROOFS OVER 6/12 PITCH: 3rd party inspection will be required, the 3rd
party inspection report will be collected at final roof inspection performed by City of
Wheat Ridge. If report is not available the final inspection will not be completed.
** � 4 1 City of Wheat Ridge
Y
Residential Roofing PERMIT - 201704587
PERMIT NO: 201704587 ISSUED: 07/21/2017
JOB ADDRESS: 4160 Brentwood ST EXPIRES: 07/21/2018
JOB DESCRIPTION: Residential Re -roof to install GAF Timberline HD asphalt shingles with 24
sq.
I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications,
applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized
by the legal owner of the roperty and am authorized to obtain this permit and perform the work described and approved in conjunction with
this permit. I further attesthat I am legally authorized to include alI entities named within this document as parties to the work to be
performed and that �c o e performed is disclosed in this document and/or its' accompayrying approved plans and specifications.
Signature of OWNER or CONTRACTOR (Circle one) Date ` !�
1. This permit was issued based on the information provided in thepermit application and accompanying plans and specifications and is
subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures.
2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and
received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building
Official and maybe subject to a fee equal to one-half of the originalpermit fee.
3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard
requirements, fees androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of
the Chief Building Official and is not guaranteed.
4. No work of any manner shall be performed that shall results in a change. of the natural flow of water without prior and specific approval.
5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required
inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services
Division.
6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any
applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection.
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
Dan Schultz q --Z)0
From: no-reply@ci.wheatridge.co.us
Sent: Thursday, July 13, 2017 10:13 AM
To: Permits CommDev
Subject: Online Form Submittal: Residential Roofing Permit Application c
S
Categories: Danny
Residential Roofing Permit Application
This application is exclusively for new permits for residential roofs and for licensed
contractors only. This type of permit is ONLY being processed online --do not come
to City Hall to submit an application in person. Permits are processed and issued in
the order they are received and due to the volume of requests, time to process
varies and is subject to change. YOU WILL BE CONTACTED WHEN YOUR
PERMIT IS READY FOR PICK-UP AND WILL BE GIVEN A SPECIFIC DATE
AND TIME WINDOW TO COMPLETE THE TRANSACTION. You will be notified if
your contractor's license or insurance has expired, and you may update those
documents at the time you are issued your permit.
For all other requests:
Homeowners wishing to obtain a roofing permit must apply for the permit in person
at City Hall. Revisions to existing permits (for example, to add redecking) must be
completed in person at City Hall. All other non -roofing permits must be completed in
person at City Hall. The Building Division will be open from 7:30-10:30 a.m.,
Monday through Friday to process these types of requests.
THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN
REROOFING UNTIL PERMIT HAS BEEN ISSUED.
Is this application for a Yes
residential roof?
How many dwelling units Single Family Home
are on the property?
PROPERTY INFORMATION
Property Address
Property Owner Name
Property Owner Phone
Number
Property Owner Email
Address
4160 BRENTWOOD ST
INEZ SEURER
303-431-0870
Field not completed.
Do you have a signed Yes
contract to reroof this
property?
It will need to be
provided at the time of
permit pick-up.
CONTRACTOR INFORMATION
Contractor Name
Contractor's License
Number (for the City of
Wheat Ridge)
Contractor Phone
Number
GLOBAL CONSTRUCTION
150246
303-593-2535
Contractor Email Address ERIC@GLOBALCONSTRUCTIONCOLORADO.COM
Retype Contractor Email ERIC@GLOBALCONSTRUCTIONCOLORADO.COM
Address
DESCRIPTION OF WORK
Are you re -decking the No (/
roof?
Description of Roofing GAF TIMBERLINE HD
Material
Select Type of Material: Asphalt
If "Other" is selected Field not completed.
above, describe here:
How many squares of the 24
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 24 /
roofing material for this
proj ect
Provide additional detail HOUSE AND GARAGE
here on the description of
z
work. (Is this for a house
or garage? What is the
roof pitch? Etc)
Project Value (contract '6600 _
value or cost of ALL
materials and labor)
SIGNATURE OF UNDERSTANDING AND AGREEMENT
I assume full Yes
responsibility for
compliance with
applicable City of Wheat
Ridge codes and
ordinances for work
under any permit
issued based on this
application.
I understand that this Yes
application is NOT a
permit. I understand I will
be contacted by the City
to pay for and pick up the
permit for this property.
I understand that work Yes
may not begin on this
property until a permit
has been issued and
posted on the property.
I certify that I have been Yes
authorized by the legal
owner of the property to
submit this application
and to perform the work
described above.
Name of Applicant DENIS KOVAL
Email not displaying correctly? View it in your browser.
C
�G Global Construction
(i 5711 East Evans Ave.
Denver, Colorado B0222
Phone: 303-757-24BO — Fax: 303-593-2535
Email: infoCelglohalconstructioncoloredo.cam
NAME C
ADDRESS ` 4o o E iw oa
CITY V J --ZIP
u
PHONE
G l= Lhic
ggS'-i'y�R�t� er5 a ny,Go m
_. L_GLOBAL CONSULTAND
Gaslamp Insurance Services
3234 Bey (tisk Court Ced6ed, CA 82010
Phony (809) 820-445 - hi (B00) 820-4197
Pmlermd Cont"etum im. Co. MAIC #12487
Policy # PCA5D25-PC217522
GENERAL CONTRACTORS LICENSE # UC244521- CLASS B
CLAIM # �✓PDUCY #
INSURANCE COMPANY
ES
it
PHONE t'- FAX
EMAIL I
DATE OF LOSS / STORM DATE
PHONE
EMESIMS
f s
TIME •
TEAR OFF EXISTING ROOF DOWN TO THE DECK. INSURANCE CONTINGENCY AGREEMENT — This estimate
INSTALL NEW FELT / UNDERLAYMENT TO MANUFACTURER SPECIFICATIONS. does not obligate the Homeowner or Global Construction in any way
unless it is approved by the Insurance Company and accepted by Global
INSTALL NEW ROOFING SYSTEM -SYSTEM TYPE Construction. By signing this agreement, the homeowner authorizes
Global Construction to pursue the homeowner's best interest for a roof
SHINGLE MANUFACTURER COLOR replacement or repair at a price agreeable to the insurance company and
to Global Construction with no additional cost to the homeowner except
_ VALLEY TYPE - OPEN CLOSED R W -VA LEY for the deductible. When the insurance company and Global
RIDG E TYP E Construction agree upon a price, that price will become the final contract
price and Global Construction will receive all ins ce proceeds e
INSTALL NEW METAL EDGING "DRIP EDGE" ON ENTIRE ROOF PERIMETER - COLOR TO MATCH ROOFING SYSTEM. work completed by Global Construction. (InitiaW
INSTALL NEW LOW PROFILE VENTS & PIPE BOOTS. PAINT TO MATCH ROOFING SYSTEM.
We propose to complete in accordance with the above specifications and subject
"ICE & H2O SHIELD" - VALLEYS, CHIMNEYS, SKYLIGHTS, AND EVAPORATJVE CO RS. to conditions found above on this proposal
6 NAIL SHINGLES.' ( r% -r, ayment to be made as follows:
STEP FLASHING, HEADWALL METAL & CHIMNEY FLASHING TO BE REPLACED, IF REQUIRED BY DDE OR IS UNUSABLE.en
m be payable to Homeowners d Global Construction
HEADWALL METAL TO BE COVERED USING THE 'BEAUTY CAP" METHOD. C, Lad)
' PROTECT LANDSCAPING. CLEAN OUT GUTTERS & ROLL YARD WITH A MAGNETIC ROLLER. GENERAL CONTRACTOR
CLEAN UP PROJECT DEBRIS DAILY AND DISPOSE OF PROPERLY. Homeowner aclarowledges Global Construction as a General
PERMIT FURNISHED BY GLOBAL CONSTRUCTION. Contractor and as such will be entitled to to% overhead and to%
profit, as allowed by insurance industry standards.
WD PERFORMED BY GLOBAL CONSTRUCTION TO MEET BUILDING CODE REOUIREMENTS.
GAF SYSTEM PLUS LIFETIME WARRANTY AVAILABLE FOR AN ADDITIONAL S DOLLARS. S YEAR WORKMANSHIP WARRANTY
BAD DECKING TO BE REPLACED AT AN ADDITIONAL $ C . 16, PER S AR� FtOG 0' _ _ GLOBAL CONSTRUCTION
EXTRA WORK t ` r.
APPRDAMATE SCOPE DF SERVICE - MATERIALS AND COST IS BASED ON CURRENT KNDWN DAMAGE REPORT. ALL INSURANCE PROCEEDS AND SUPPLEMENTS (RCV) PWS THE DEDUCTIBLE ARE PAYABLE AS FOLLOWS:
APPROMMATE COST $ (PWS PERMIT, SUPPLEMENTS AND TQ
APPROMMATE DATE OF SERNCE
/ o / f DEDUCTIBLE AMOUNT PAID BY INSURED $
THE CONSUMER PROTECTION / ROOFING BILL (SB -38) DOES NUT ALLOW A ROOFING COMPANY OR CONTRACTOR TO WAIVE, PAY FOR OR REBATE THE HOMEOWNER'S INSURANCE DEDUCTIBLE IN PART OR IN WHOLE.
PAYMENT FOR WORK CONTRACTED By G1.13E3AL CDNSTRUCTIDN IS DUE UPON COMPLETION _T _ (initial) '
ACCEPTANCE OF PROPOSAL — This proposal becomes the legal and binding contract
yz hours from date of acceptance. 1 1/2 percent per month interest will be added to all
accounts 3o days past due. In addition, costs and reasonable attorney's fees for collection
may be charged on any account past due over 3o days. Payment is to be made at time of
completion. Warranty will be void if payment is not made in full within 3o days. Failure to
pay can constitute a mechanical lien filed against the property. All material is guaranteed to
be as specified. All work to be completed in a workmanlike manner to standard practices.
All interior damages to buildings are excluded go days after completion date and the owner
is notified that any damage to contents will be the responsibility of the owner and his
insurance company. All damages to the building, which occurred while roofing was in
progress, will be covered by the contractor. All agreements are contingent upon strikes,
accidents or delays beyond. Global Construction is not responsible for broken driveways.
Scheduling will be done based upon date signed but limited by availability for materials,
crews, and weather conditions. Re roofing does not include decking.
SIGNATUREDATE LL
CUS15MER
SIGNATURE
DATE
CUSTOMER
9-
SIGNATURE DATE. !T
I GLOBAL CONSTRUCTION CONSULTANT
Inspection Type:
Job Address:
Permit Number:
CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
)3) 235-2855 Office • (303) 237-8929 Fax
1 SPECTION NOTICE
1 Ni=l
S7—
b/
i / %(--) 6 7-
I
t:
❑ No one available for inspection: -Time./ AM/PM
Re -Inspection required: Yes No
When corrections have been made, call for re -inspection at 303-234-5933
Date: l� Inspector:
AIS
DO NOT {'REMOVE NOTICE
INSPECTION RECORD Occupancy/Type
Ia zed ~a3fc~~er~ INSPECTION LINE: (303) 4-5933
21
Inspections will not be made unless this card is posted on the building site
Call by 3:00 PM to receive inspection the `following business day.
INSPECTOR MUST SIGN ALL SPACES PERTAINING TO THIS JOB
'
FOUNDATION INSPECTIONS DATE INSPECTOR INITIALS COMMENTS:
Footings/Caissons
Stemwall /!(CEG) Concrete
Encased Ground
Reinforcing or Monolithic
Weatherproof / French Drain
J j
Ai
Plumbing
Mechanical
Roof
Building Final
Fire Department
R.O.W & Drainage
Parking & Landscaping
**NOTE: ALL ITEMS MUST BE COMPLETED: AND APPROV
CERTIFICATE OF OCCUPANCY is ISSUED. FINAL INSPEI
OF A CERTIFICATE OF OCC
OCCUPANCY NOT PERMITTED UN
PROTECT,THIS
I 11
OM THE WEATHER
~OF NtFiEgTpr City of Wheat Ridge Building Division
m 7500 W. 29th Ave., Wheat Ridge, CO 80033
- = Office: 303-235-2855 * Fax: 303-235-2857
- o Inspection Line: 303-234-5933
OtORP~
Date: L q b (3'
Plan
Permit Clg6567
Building Permit Application
Property Address: ~f /U'? Ti 7n C
2e3--~i'3i 7a
Property Owner (please print): /n1-I/) ~ j e"A 1-'2 r- Phone:
Mailing Address: (if different than property address)
Address:
City, State,
Contractor: „2nrt,tJ J1e?S'`are,
Contractor License Phone: 6 l
Sub' Contractors-
Electrical City License Plumbing City License Mechanical City License
Company: Company Company:
Exp. Date: Exp. Date: Exp. Date:
Approval: Approval: Approval:
Use of space (description): Construction Value: $ y~
Description of work: (as calculated per the Building Valuation Data sheet)
30)rf, §A/- f- fv/ k) Plan Review (due at time of submittal): $
Sq. Ft./L.Ft added: Squares -D U BTU's Gallons Amps
OWNERICONTRACTOR 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 (I.B.C) and all other applicable Wheat Ridge Ordinances, for work
under this permit. Plans subject to field inspection.
CIRLCE ONE:: (OWNER)..., (CONTRACTOR) or PERSONAL REPRESENTATIVE of (OWNER) (CONTRATOR)
PRINT NAME: r? 1 n 1 S 2A--7 a, SIGNATURE: Dater ~
'~W'~""'"'''~~''''f~''''\'''''''''''"';'''''''''W'''''''''''''''''''''J",~r"",''''''"' .,1.111"",,,",,,,,,,,, "",4,,, 'p. '"""""""T""""""""""""""''!''''l',!J~", ~,~..""", ,,~
'J "", ",',,", ,',' ' '1
" bEPARTMENT OFPLANNltllG AND DEVELOPMENT Building Permit Number: ,17 '
BUILDING INSPECTIO. N DIVISION - 235-2855:.'~.'1 1
CITY OF WHEAT RIDGE Date: 5f14/97
7500 WEST 29TH AVENUE "'ll:
WHEAT RIDGE, CO 80215 ..~
t,
I
,!f'
~;
Phone: 431-087otl
.it
Phone: 455-17141
i>
Property Owner:
Property Address: 4160 BRENTWOOD ST
Contractor License No,: 19475
Company: NIETO'S ELECTRIC, CO
I hereby certify thatlhesetbacl<d1stances proposed by this pennn application are accurate,
and do not vi<>iate. appJ1cat>1e ordinances, ruleS or regulations 01 the City 01 Wheat Ridge or
covenants, easements or restrictions of record; that all measurements shown, and allegations
made are accurate; that I hayt> read andaQree to abide by all conditions printed on this
application, and that I assume luli responsIbility for compliance wnh the Wheat Ridge Building
Coda (U,B,C,) and all Other applicable at Fl~ ordinances for woll< under this permit
(OWNER)(CONTRACTOR) SIGNE r. AfE.!!}t'f/9,
Total:
~ '
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
Construction Value:
Permit Fee :
Plan Review Fee:
Use Tax:
Description :
UGRADE SERVICE TO 150 AMP
BUILDING DEPARTMENT USE ONLY
SIC:
Sq, Ft:
I
I
I
I
,j
II
~ 'l
Jj
. .
Approval:
Occupancy:
Walls:
Roof:
Stories :
Residential Units :
Electrical License No :
Company:
Plumbing License No :
Company:
Mechanical License No :
Company:
i:
11
, I
Expiration Date:
Approval :
.
Expiration Date:
Approval:
.
Expiration Date :
Approval :
.
(1) This perrntt wasis8ued in accordance with the prQVisions set forth m yopur application and Is sublect to the laws of the State of Colorado and to th , ning
Regulations and Bulldlnn COde otVVheat Ridge, Colorado or any other appUcabJe ordinances of the City. ,..'~:
(2) This permit shall expire if (A) the work authonzed is not commenced within sixty (60) days from issue date or (8) the building authorized is suspef.:or
abandoned for a periodof120 dayS. , ' ~'::
(3) Ifthts permit expfreS, a newpemut may be acquired for a fee of one-half the amount normally required, provided no changes have been or will be " ,,', e In the
original plans and speo 'flca tions and any suspension or abandonment has not exceeded one (1) year. If changes are made or If suspension or a. .... nment
exceeds one (1) year, fuft fees shall be paid for a new permit. , )
(4, No work of any manner allaU be done that will change the natural flow of water causing a drainage probtem. '; ,:
(5) Contrac:tor shall notify the Building Inspector twenty-four (24) hours In advance for all inspections and shan receive written approval on inspeCtion. ,before
proceednng with successive ph.... oIlhe job, ill!
(6) The issuance ofa pennit or the approval of drawings and specifications shall not be construed to be a pennit for, nor an approval of. any violation 0JP18 provisions
O,f the bu ngOl 'other ordinance, law, rule or regulation. ,!~,
.~
,
Chie Building In actor .11
THIS PERMI, VALID ONLY WHEN SIGNED BY THE CHIEF BUILDING INSPECTOR AND MA YoI
CALL: 234-5933 24 HOURS PRIOR TO INSPECTION'[ii
_~~i
%.
iffi'
11: : :J) ~1~
Wi
;#.r~
~ ~ '.j\i
~
Ii
\.
!
DEPARTMENT OF PLANNING AND DEVELOPMENT Building Permit Number:
BUILDING INSPECTION DIVISION - 235-2855
CITY OF WHEAT RIDGE Date:
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80215
Property Owner:
Property Address:
Contractor License No, :
Company:
f1:.:a R. V
L/.l (,:. 0
lei'!?!'
IJ 1,=1~'J
5'= [,t i2 EI2.
-B12.~"1-'-' C'cO Sj..
Phone: ,+:3 f -08'7 U
t L C'crT2.;<.. C,.
Phone: 4S-S-/7/y
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
Construction Value: 'f) CX::>~.!? -
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.
(OWNER)(CONTRACTOR) SIGNE~d<;; A. ~'It<<i2;;s", DATE .sj;.J9?
Description: U /.2. r? ~'" _ '" ( ;)2)
L/~~ ~~~~~ .
BUILDING DEPARTMENT US
Total:
~()nlnlr.CPl'flme-rmg
Approval:
Zoning:
BUlldl~olflmenu;;:]
Approval:
Ii!!.t)IICl.WlH'lam.;ommen~
Approval:
SIC:
Sq. Ft:
Occupancy:
Walls:
Roof:
Stories:
Residential Units:
Electrical License No: c ' Plumbing License No :
Company: ;J I rcTZo IJ t::; ( ECTIlI' G(;ompany :
Mechanical License No :
Company:
. ;1" ~I_,- I j ~
Expiration Date:
Approval:
. e!mm.~!mt_
Expiration Date:
Approval:
Expiration Date:
Approval:
III
.
,'": li~Lm .
141
51
(6)
This permit was issued in accordance with the provisions set forth in yopur application and is subject 10 the laws of the State of Colorado and to the Zoning
Re,gulations and Buildin~ 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 tees shall be paid for a new permit.
No work of any manner shall ,be done that will change the natural flow ot water causing a drainage problem.
Contractor shall notify the BUIlding Inspector tw, enty-four (24) hours m advance for all mspectlons and shall receive written approval on inspection card before
proceedimg 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 or, 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