HomeMy WebLinkAbout3215 Allison StreetPERM I . � /U%% ADDRESS• JOB CODE:
Rough Inspection (continued)
Date
Inspector
Initials
Comments
316 Rough Mechanical Residential
317 Rough Mechanical Commercial
318 Boiler / Furnace
�
319 Hot water tank
ALOIDE
320 Drywall screw and Nail
321 Moisture board / shower walls
322 Rough Grading
323 Miscellaneous
Final Inspections
Date
Inspector
Initials
Comments
402 Gas Meter Release
403 Final Electrical Residential
404 Final Electrical Commercial
�
405 Final Mechanical Residential
ALOIDE
406 Final Mechanical Commercial
407 Final Plumbing Residential
408 Final Plumbing Commercial
409 Final Roof
410 Final Window/Door
411 Landscape/Park/Planning*
Inspections from these entities shall be requested
one week in advance.
*For landscaping and parking inspections please
call 303-235-2846
**For ROW and drainage inspections please call
303-235-2861
***For fire inspections please contact the Fire
Protection District for your project.
412 Row/Drainage/Public Works'
413 Flood plain Inspection**
414 Fire Insp. / Fire Protection***
415 Public Works Final**
416 Storm Water Mgmt.**
417 Zoning Final Inspection*
418 Building Final Inspection
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 by the Fire District and
Electrical low voltage by the Building Division.
INSPECTION RECORD
Inspection online form: http://www.ci.wheatridge.co.us/inspection
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 MIDNIGHT (11:59 PM) to rece4Ve a;n:inspection the following business day
PERMIT: % , ADDRESS.' �`�. .� " "JOB CO
: DE:
Foundation Inspections
Date
Inspector
Initials
Comments
102 Caissons / Piers
103 Footing / P.E. Letter
104 Foundation Setback Cert.
105 Stem Walls
106 Foundation wall Insulation
Do Not Pour Concrete Prior To Approval Of The Above Inspections
Underground I Slab Inspections
Date
Inspector
Initials
Comments
201 Electrical / Cable/ Conduit
202 Sewer Underground Int.
203 Sewer Underground Ext.
204 Plumbing Underground Int.
205 Plumbing Underground Ext.
206 Water Underground
I O ))
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, t)
Do Not Cover Underground or Below / In -Slab Work Prior To Approval Of The Above Inspections
Rough Inspection
Date
Inspector
Initials
Comments
301 Rough Framing
302 Wall Sheathing
303 Roof Sheathing
304 Sheer Inspection
305 Insulation
306 Mid -Roof
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307 Metal / Lath / Stucco
308 Rough Electrical Residential
309 Rough Electrical Commercial
310 Electrical Meter Residential
311 Electrical Meter Commercial
312 Temp. Const. Meter
313 Rough Plumbing Residential
314 Rough Plumbing Commercial
315 Shower Pan
SEE OVER FOR ADDITIONAL INSPECTIONS
A i CITY OF WHEAT RIDGE
_1�9rBuilding Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office o (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: U�' FlWt eCOK-
Job Address: 3Q !S A L L_ i '� _71
Permit Number: Z">1:� o tr) / (,
LJ No No one available for inspecti Time AM PM
Re -Inspection required: Yes No
When corrections have been made, call for r ' spection at 303-234-5933
Date: 1 ! Inspector:
DO NOT REMOVE THIS kOTICE
41 CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: 90 f
Job Address:
Permit Number: '-.Zko / 70 7/
❑ No one available for inspection ime QRT__
AM/PM
Re -Inspection required: Yesto
When correct" ns have been made, call for re -inspection at 303-2_ 3q-5933
Date: % 7 Inspector:—M
DO NOT REMOVE THIS NOT/CE
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: '10 9- (,_ . n n i
Job Address: -:!>-,9 ) 5-- 19 ) if s e n S4
Permit Number: a 0 17 0 r-1 `7 1 to
a.rE 1IfN
1 Jo 1£//P lAr C 0 it �r`Ar In r-
fl ztoy `, AJfA h�• /
❑ No one available for inspection: Time 9 = 3 3 A PM
Re -Inspection required: Yes No
When corrections have been made, call for re -inspection at 303-234-5933
Date: 11 `7 /7 Inspector: _7_1�
DO NOT REMOVE THIS NOTICE
City of Wheat Ridge
Residential Roofing PERMIT - 201704716
PERMIT NO: 201704716 ISSUED: 07/25/2017
JOB ADDRESS: 3215 Allison ST EXPIRES: 07/25/2018
JOB DESCRIPTION: Residential Re -roof to install GAF Timberline HD Mission Brown asphalt
shingles with ROOF DECKING - 21.53 sq.
*****Revision doing whole duplex roof adding 7.22sq of GAF Timberline
asphalt shingles to complete roof****
3209 Allison St is the second half of duplex***
*** CONTACTS ***
OWNER (303)229-3315 BRYANT KELLY S
SUB (303)750-4295 Seth Curry 170393 4th Dimension Concepts
*** 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: 18,705.00
FEES
Total Valuation 0.00
Use Tax 392.81
Permit Fee 346.95
** TOTAL ** 739.76
*** 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 (projec~,
address) has been applied in accordance with the installation instruction for (roof
material brand name) roof covering" is required to be on site at the time of final
inspection.
Roof inspections for ROOFS OVER 6/12 PITCH: 3rd party inspection will be required, the 3rd
party inspection report will be collected at final roof inspection performed by City of
Wheat Ridge. If report is not available the final inspection will not be completed.
City of Wheat Ridge
s
j� Residential Roofing PERMIT - 201704716
PERMIT NO: 201704716 ISSUED: 07/25/2017
JOB ADDRESS: 3215 Allison ST EXPIRES: 07/25/2018
JOB DESCRIPTION: Residential Re -roof to install GAF Timberline HD Mission Brown asphalt
shingles with ROOF DECKING - 21.53 sq.
*****Revision doing whole duplex roof adding 7.22sq of GAF Timberline
asphalt shingles to complete roof****
3209 Allison St is the second half of duplex***
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_per t. I further attest that I am legally authorized to include all entities named within this document as parties to the work to be
perform and that all worl be performed is disclosed in this document and/or its' accompanying approved plans and specifications.
la 10
Si ature o O R or CONTRACTOR (Circle one) Date
I, hi rmit was issued based on the information provided in the permit application and accompanying plans and specifications and is
su aect 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 originalermit fee.
3, If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard
requirements, fees and procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of
the Chief Building Official and is not guaranteed.
4. No work of an manner shall be performed that shall results in a 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
applica a or any ordinance or regul ion 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.
4 4Q
917 City of
Wheat dge
COMMUNITY DEVELOPMENT
Building & Inspection Services Division
7500 W. 29th Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933
Email: permits(a)ci.wheatridge.co.us i_\0
Building Permit Revision/Amendment Application
FOR OFFICE USE ONLY
Date: I
ci
Add to Permit # rV"
*** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. ***
Property Address:
Property Owner (please print): \ U✓yL C' Y Phone: �Cg -1$ 3 -0((7q
Property Owner Email:
Mailing Address: (if different than property address)
Address
City, State, Zip:
fk
S
Contact Person:. C5� �_ i � � Phone: �}Z� (�Cj X2'32
Contractor: g\,nA (-, V� S r C� Co VA,(' e
Contractors City License #:
Contractor E-mail Address:
Phone:_ _'� 0-5 — - 76 `- C12
L a (,0 VV."_
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:
Sq. Ft./LF
L °J Cq
Btu's
Gallons
Amps
Squares
Other
2 -
Value: (Mint-inglude alljgeneral and subcontracted work to be performed related to revisions/amendments described above)
OWN CO RACTOR 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.
CIRCLE ONE: (OWNER) CONTRACTOR or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) �
PRINT NAME: 't Cc vL�� �G-g SIGNATURE: DATE:
N
ZONING COMMMENTS:
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
DEPARTMENT USE ONLY
OCCUPANCY CLASSIFICATION:
Building Division Valuation: $
A i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: 3 o e - d
Job Address: !34.
Permit Number: -22 17 o ti 7/ b
❑ No one available for inspection: Time 1)= / l6/0 M
Re -Inspection required: Yes
When corrections have been made, call for re -inspection at 303-234-5933
Date: / a /" / 1-7 Inspector: _T 7S
DO NOT REMOVE THIS NOTICE
A City of Wheat Ridge
Residential Roofing PERMIT - 201704716
PERMIT NO: 201704716 ISSUED: 07/25/2017
JOB ADDRESS: 3215 Allison ST EXPIRES: 07/25/2018
JOB DESCRIPTION: Residential Re -roof to install GAF Timberline HD Mission Brown asphalt
shingles with ROOF DECKING - 21.53 sq.
*** CONTACTS ***
OWNER (303)229-3315 BRYANT KELLY S
SUB (303)750-4295 Seth Curry 170393 4th Dimension Concepts
*** 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: 18,705.00
FEES
Total Valuation 0.00
Use Tax 392.81 PAID
Permit Fee 346.95
** TOTAL ** 739.76
*** COMMENTS ***
*** CONDITIONS ***
Effective December 1, 2014, asphalt shingle installations require an approved midroof
inspection, conducted when 25-75 percent of the roof covering is installed, prior to final
approval. Installation of roof sheathing (new or overlay) requires an approved inspection
prior to installation of ANY roof coverings and is require on the entire roof when spaced
or board sheathing with ANY gap exceeding one half inch exists. Asphalt shingles are
required to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and
water shield is required. Eave and rake metal is required. A ladder extending 3 feet above
the roof eave and secured in place is required to be provided for all roof inspections.
Roof ventilation is required to comply with applicable codes and/or manufacturer
installation instructions, whichever is more stringent. In order to pass a final inspection
of elastomeric or similar type roof coverings, a letter of inspection and approval from the
manufacturer technical representative stating that "the application of the roof at (project
address) has been applied in accordance with the installation instruction for (roof
material brand name) roof covering" is required to be on site at the time of final
inspection.
Roof inspections for ROOFS OVER 6/12 PITCH: 3rd party inspection will be required, the 3rd
party inspection report will be collected at final roof inspection performed by City of
Wheat Ridge. If report is not available the final inspection will not be completed.
City of Wheat Ridge
Residential Roofing PERMIT - 201704716
PERMIT NO: 201704716 ISSUED: 07/25/2017
JOB ADDRESS: 3215 Allison ST EXPIRES: 07/25/2018
JOB DESCRIPTION: Residential Re -roof to install GAF Timberline HD Mission Brown asphalt
shingles with ROOF DECKING - 21.53 sq.
I, by my signature, do hereby attest that the work to be performed shall comply with all accompanyingg 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_permit. I further attest that I am legally authorized to include all entities named within this document as parties to the work to be
pert ed and that :!����onneds disclosed in this document and/or its' accompanying approved plans and specifications.
Signature of OWNER or CONTRACTOR (Circle one) Date
1. This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is
subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures.
2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and
received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building
Official and may be subject to a fee equal to one-half of the originalpermit fee.
3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard
requirements, fees androcedures for approval of any new permit. Re -issuance or extension of expired 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 re uired
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
applicab�gde or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection.
--7(,-
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
Dan Schultz el_ 66 l l/`7` -A&
From:
no-reply@ci.wheatridge.co.us
Sent:
Monday, July 17, 2017 1:33 PM
To:
Permits CommDev
Subject:
Online Form Submittal: Residential Roofing Permit Application
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 3215 allison st wheat ridge CO 80033
Property Owner Name Kelly Bryant
Property Owner Phone (303) 229-3315
Number
Property Owner Email Kelly. Bryant@computershare.com
Address
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
4th Dimension Concept
-- l 7 U 313
7206970232
Contractor Email Address jcontreras@4thdc.com
Retype Contractor Email jcontreras@4thdc.com
Address
DESCRIPTION OF WORK
Are you re -decking the Yes
roof?
Description of Roofing GAF , laminated shingles, timberline HD mission Brown
Material
Select Type of Material: Asphalt
If "Other" is selected Field not completed.
above, describe here:
How many squares of the 19.63
material selected above?
Does any portion of the
property include a flat
roof?
If yes, how many squares
on the flat roof?
No ✓
Field not completed.
TOTAL SQUARES of all 21.53
roofing material for this
project
Provide additional detail House and shed remove and replace asphalt shingles, 4/12
here on the description of
z
work. (Is this for a house
or garage? What is the
roof pitch? Etc)
Project Value (contract
value or cost of ALL
materials and labor)
,705
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 Jorge Contreras
Email not displaying correctly? View it in your browser.
3
41h Dimension Concepts, LLC
Pts 'fenvv t 4',�eat Stagy o� G'a�o o!
Ye10 f-------,
PROPERTra
IRIV.
Rt YPHONE
22?331,
g'r ADDRESSSECONDARY
3214 A 1J,5n
PHONE
MCI3y, 21
EMAIL
MAIL ADDRESS
t!X
NSVRANCECOWANYCLAIM p
PRO1sO5A�_tfATE117
JJCC
Scope 0 Walk:
ng Manufacturer c
�— `` b �p
i r
Roofing product_ rrs�j,,,,4! 140 Ronfine Cnier <5 fD� �lf';�I„
5 year Roofing Labor Warranty
®4 Liability Insurance �egister.
C- $1,000,000 Manufacturer Warranty
rPr,9Ro1-
vdeCity Building Permit
L� Tear off Layer(s) of Composition & Layer(s) of cR
Decking& Attic
I�rt�n et1 nr,.,v rlPclrir�, [�'(eplace Damaged Decking Where Necessary
l Starter Course Shingles
Edge
�statl Underlayment _ L er r. ❑ Install Ice & Water Shield along Eaves & all Protrusions
stall Drip (Color-
Fo y valleys using ❑Install Valleys — Closed � Open— (W)
❑ Install Upgraded Ridge Vent System
Ins II New Turtle Vents ❑ Install New.Step Flashing (sidewall, chimney, skylights)
❑ Install Upgraded High Profile Ridge Cap
;:nstall Classic We Ridge Cap PlInstall New Vent Pipe flashing (aka. jack or boot)
❑ Innsjstall Design Course along Headwalls
❑ Remove & Cover ❑ Detach & Resre
['Sweep Site with Magnetic Roller
Clean Up Trash & Clean Out Gutters Q Other
Approximate Date(s) of Service: %" 2q-17 PaymentTerms: Z it tk4rao re Pr'o c
(0 Dimension Concepts is not responsible for any property and casualty insurance carriers delay or denial of an insurance claim, in whole or in part).
WORK TO BE COMPLETED IN ACCORDANCE WITH THE SPECIFICATIONS ABOVE FOR THE COST OF: $
Dollars
By approving this agreamelt, the property owner authorizes Jr Dknenslon Concepts, LLC to represent the best Interests of the property owner for restoration of
damages. a Dimension Concepts• LIC shall communicate with the property and casually inwrance company to come to an agreement for works to be performed.
Foiknwk% approval of claim, 4" Dimension Concepts, LLC will complete specified work for a price agreeable to the insurance company and to 4" Dimension
Concepts. LIC with no additional can to the property owner except for the deductible. This agreed upon price shall become the final contract price, and 4'"
Dimeaskm Concepts, LLC wil ve all insurance proceeds for work completed by a Dimension Concepts. CLC.
The property owner I; not intending to make payment from the proceeds of a property and casualty insurance policy. Pursuant to C.R.S. Section 6-22-305,
4111 Dimension Concepts cannot pay, waive, rebate or promise to pay, waive or rebate all or part of any insurance deductible applicable to the insurance dalm for
payment for work on the covered property. 4" Dimension Concepts shall held In trust any payment received within financial Institution until the delivery of
t mted2hL
Signature
1730 S. Abilene St. Suite 204
Amara. CO 80022
www.4thdc.com
A (5'fft s ev'ra r
. � -Z� //-7
AccenWice Date
S-26
Acceptance Date
Office: (303) 750-4295
Fax: (303) 459-5111
A i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: 3 o e - d
Job Address: !34.
Permit Number: -22 17 o ti 7/ b
❑ No one available for inspection: Time 1)= / l6/0 M
Re -Inspection required: Yes
When corrections have been made, call for re -inspection at 303-234-5933
Date: / a /" / 1-7 Inspector: _T 7S
DO NOT REMOVE THIS NOTICE
F OFFICE USE ONLY
,� �� + +r•
on
}
if
Ptt�IlC
Property Owner ma -
Ad dress: (it different than property address)
Address:
+Co i all information on BOTH sides of this form
S �a iigg ��!! q .w egg Gallo
7�. db.f • L SSi�� 47C�SSo.1
,Arms Squares Other