HomeMy WebLinkAbout4495 Balsam Streetr Sf 40
INS 10 CORD
INSPECTION ONLINE FORM: http://www.ci.wheatridge.co.us/forms.aspx?fid=79
od:::� INSPECTION REQUEST LINE: (303) 234-5933
Occu anc A�_e
Inspections will not be performed unless this card is posted on the project site.
Call the inspection request line before 11:59 p.m. 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 Ap roval Of The Above Inst
Underground/Slab Inspections Date Inspector
Initials Comments
Electrical
Sewer Service
Plumbing
Do Not Cover Underground or Below/In-Blah Wnrk Prinr Tn Ans ri._ A 1____
Rough Inspections
Date
Inspector
Initials
- ..... ...+v�v ■opo N�iyNV l 1.!
Comments
Wall Sheathing
Mid -Roof
Lath / Wall Tie
Rough Electric "
Rough Plumbing/Gas Line
Rough Mechanical
Rough Framing
Rough Grading
Insulation
Drywall Screw/ Nail
Final Inspections
Date
Inspector
Initials
Comments
Landscaping & Parking / Planning Dept.
Inspections from these entities should be requested
one week in advance. For landscaping and parking
inspections call 303-235-2846. For ROW and drainage
inspections call 303-235-2861. For fire inspections
contact the Fire Protection District for your project.
ROW & Drainage / Public Works Dept.
Floodplain Inspection (if applicable)
Fire Inspection / Fire Protection Dist.
Final Electrical
Final Plumbing
Final Mechanical
Roof
Final Window/Doors
C
T n,°-�-
E'
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 voltaae hermits— PIPasP hP cures ihnr — ink
by the Building Division.
viau wi ai iu cicLuicai iow voiiage
Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued
Protect This Card From The Weather
City of Wheat Ridge
Residential Roofing PERMIT - 201702078
PERMIT NO: 201702078 ISSUED: 06/19/2017
JOB ADDRESS: 4495 Balsam ST EXPIRES: 06/19/2018
JOB DESCRIPTION: * Tear off existing roof to deck and replace 28 SQ
*** CONTACTS ***
OWNER (303)910-0238 MERENDA DIANE M
GC (303)233-7663 Ben McFerron 070157 Premier Roofing Company
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 7,196.00
FEES
Total Valuation 0.00
Use Tax 151.12
Permit Fee 172.60
** TOTAL ** 323.72
*** 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 A1/2 -inch exists. Asphalt shingles are required to
be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield is
required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave
and secured in place is required to be provided for all roof inspections. Roof ventilation
is required to comply with applicable codes and/or manufacturera€lms installation
instructions, whichever is more stringent. In order to pass a final inspection of
elastomeric or similar type roof coverings, a letter of inspection and approval from the
manufacturer's technical representative stating that "the application of the roof at
(project address) has been applied in accordance with the installation instruction for
(roof material brand name) roof covering" is required to be on site at the time of final
inspection.
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: j:jD
Job Address: SR m
Permit Number: 1 70 dy7
❑ No one available for inspection: Time./D AM/PM;'
Re -Inspection required: YesNo
ca;%
When corrections have been made, call for re -inspection at 303-234-5933
Date:lo%o-)1/7 Inspector: JC)Al 61, lbl�rl_
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
_:�9�Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: D
Job Address: 4 9 RA/ S P m T
Permit Number: D U I -7 6 ?, o-71�
(fir IF P P 0 v -c_ 7
0 (XPj S?i/1 7�rlrZ��� G
�7;N-�1�s
❑ No one available for inspection: Time / �' AM/PM
Re -Inspection required: Yes No
11 When corrections have been made, call for re-ir�.spectil n at 303-234-5933
Date: / % � Inspector:
DO NOT REMOVE THIS NOTICE
City of Wheat Ridge
a
Residential Roofing PERMIT - 201702078
PERMIT NO: 201702078 ISSUED: 06/19/2017
JOB ADDRESS: 4495 Balsam ST EXPIRES: 06/19/2018
JOB DESCRIPTION: * Tear off existing roof to deck and replace 28 SQ
*** CONTACTS ***
OWNER (303)910-0238 MERENDA DIANE M
GC (303)233-7663 Ben McFerron 070157 Premier Roofing Company
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 7,196.00
FEES
Total Valuation 0.00
Use Tax 151.12
Permit Fee 172.60
** TOTAL ** 323.72
*** 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 W2-inch exists. Asphalt shingles are required to
be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield is
required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave
and secured in place is required to be provided for all roof inspections. Roof ventilation
is required to comply with applicable codes and/or manufacturera€TMs installation
instructions, whichever is more stringent. In order to pass a final inspection of
elastomeric or similar type roof coverings, a letter of inspection and approval from the
manufacturer's technical representative stating that "the application of the roof at
(project address) has been applied in accordance with the installation instruction for
(roof material brand name) roof covering" is required to be on site at the time of final
inspection.
a
PERMIT NO:
JOB ADDRESS:
JOB DESCRIPTION
City of Wheat Ridge
Residential Roofing PERMIT - 201702078
201702078 ISSUED: 06/19/2017
4495 Balsam ST EXPIRES: 06/19/2018
* Tear off existing roof to deck and replace 28 SQ
I, by my signature, do hereby
applicable building codes, an
by the legal owner of the PA
this,permit. I further atte f`thz
performed and that allorkt+
I the work to be performed shall comply with all accompanying approved plans and specifications,
nd
cable municipal codes, policies and procedures, athat I am the legal owner or have been authorized
am authorized to obtain this permit and perform the work described and approved in conjunction with
ally authorized to include all entities named within this document as parties to the work to be
rmed is disclosed in this document and/or its' accompanying approved plans and specifications.
Signature of --`OWNER or CONTRACTOR (Circle one) Date
I . This hermit 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 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 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'' y 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 11:59PN 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 ay t -4- (3 0-� tT
From: no-reply@ci.wheatridge.co.us
Sent: Friday, June 9, 2017 10:43 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 3-5 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.
PROPERTY INFORMATION
Property Address
Property Owner Name
Property Owner Phone
Number
Property Owner Email
Address
Do you have a signed
contract to reroof this
property?
It will need to be
provided at the time of
permit pick-up.
4495 Balsam St
Dianne Merenda
303-910-0238
Field not completed.
Yes
CONTRACTOR INFORMATION
Contractor Name Premier Roofing Company
Contractor's License
070157
Number (for the City of
Wheat Ridge)
Contractor Phone
3039526873
Number
Contractor Email Address
amccoy@premier-roofing.com
(permit pick-up
instructions will be sent
to this email)
Retype Contractor Email
amccoy@premier-roofing.com
Address
DESCRIPTION OF WORK
Is this application for a
Yes
new permit for a
residential roof?
Are you re -decking the
No
roof?
Description of Roofing
Tear off existing roof to deck and replace.
Material
Select Type of Material:
Asphalt
If "Other" is selected
Field not completed.
above, describe here:
How many squares of the
27.66
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
27.66
roofing material for this
proj ect
z
Provide additional detail 26.33 SQ's for House and 1.33 SQ's for Shed. Pitch: 4/12 and
here on the description of 2/12
work. (Is this for a house
or garage? What is the
roof pitch? Etc)
Project Value (contract 6,915.00
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 Alison McCoy
Email not displaying correctly? View it in your browser.
3
- Denver
Colorado springs MIS 01
Kansas City
PREMIER 1-s55-nooF-3Z1 Fora Collins
ROOFING COMPANY
www.premier-roofing.com Chicago B
AGREEMENT
THIS AGREEMENT SUBJECT TO INSURANCE COMPANY APPROVAL
Name: D%.f v a ArrenW4 Date:�--
Address: ylf93 City/State: wltr0rJsL LD —Zip: -9,6y33
Email: Best Phone: -fo - 9vn - 0R3k'
Bill' g Address: u City/State: Zip:
,SIS 15 Slope o Low Slope
r}I%s' ion Shingle ❑Wood aMetal ❑Other:
SO ly Membrane: ❑Modified ❑Built Up
o f Grade: �59 y Ridge/ ' `
itch:
_ZJ12 2 -Story- oYgl Diff. Access: cYgN
ers: Ty0s:
-king Type:Olywood/OS ❑Spaced ❑Ot er
rFr�'s eners per shingle:#oStaplesaKails
of k Protection:
ley material: LF
e 7 s V Turbines Bath Ridge LF
gFIu ng -Jacks: Sm-Lg.-
Edging
mLg_,WEdging cs'S'oN oRakes ❑Eaves
Flashing oCounter Fling oReglet ❑Other
lights: ❑Reflash ❑Reface ----#-Size
a eak Barrier Existing moi'❑N
WARRANTIES: Weat r Stopper System: ❑N
Workmanship: ❑2 Yr 10 -Yr Premier 5 -Yr Golden Pledge
Material : ❑5 -Yr (Shingle Only) 0 -Yr Full System
PAYMENT SCHEDULE
First (ACV) or 1/3 payment due on day of construction Final payment due upon Invoice
Paid Date: L / CK# @$
Paid Date:_ �_ CK# @$ _
Paid Dater_/^ CK# @$
State Law: Any Payments to Be Held in Trust
Premier Roofing shall hold in trust any payment received from you
until Premier Roofing has delivered roofing materials at the site or
has performed a majority of roofing work on your property.
North Slope: Roofing:
Q0-r
South Slope:
East Slope:
West Slope:
Other Damages:
Recommendations:
Wlemove Roof to Deck and Replace M66t Repair
rt t
Ridge: C( d3c Deck �tection:_�
�
Remove: 6fing d0'eck Protection cKashing
Install:
earrie at:
av,�s i dewalls d�ileys oPig6etrations ❑ kyiights
mJ 6" ners Per Shingle-
o-f(ept"ace Vents �A�stal�IR�ake
Flashing
Gutter Apron etal
All Roof Accessoriestt Landscaping
e e Ail Debris with Magnet
p Property g
rnlsh Permit (Where Required)
❑Special Project Upgrades:
Quantity: Unit
Price: _,__ (in addklon to Insurance proceeds and deductible)
❑Special Property Protection Measures:
Terms:
This agreement does NOT obligate the property owner or PREMIER ROOFING in any way unless the insurance claim is
approved by the insurance company and accepted by PREMIER ROOFING. By signing this agreement the property owner
authorizes PREMIER ROOFING to pursue property owner's best interests for a roof replacement at a "PRICE AGREEABLE"
to the insurance company and PREMIER ROOFING with no cost to the property owner excerpt for the Insurano deductible.
When "PRICE AGREEABLEji5 determined, the final contracf amount shall be equal to the Insurange Proceeds and
1?eductibl% and property o et au lzes PREMIER ROOFING to provide labor and material In accordance with this
Agreement and the s i atioout herein and on the reverse side hereof to accomplish the roof replacement.
Accepted by: Date: J -Z
InsuranceCo.: Claim#: -77 leY'70 1503
Mortgage Co.: Deductible Amount:$
Fleld Representative: (r) - Management Approval:
Scanned by CarnScanner
i 1CITY OF WHEAT RIDGE
-1�9�Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: flo
Job Address: l/ Z/ y �— 619L e
Permit Number: "7 0/ `" 0 2 Ci
❑ No one available for inspection: Time O � Ci AM/PM
Re -Inspection -.required.. Yeo__.._______._.____.
When corrections have been made, call for re-insp9ption at
Date: (-- " ' Inspector:
DO NOT REMOVE THIS NOTICE
41
CITY OF WHEAT RIDGE
Building Inspection Division
� �(303)
(303) 234-5933 Inspection line
235-2855 Office * (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type:
Job Address:
Permit Number:
-7 0 0 2 0
L) No one available for insypi Timed 0
ion: i rn AM/PM
Re-Inspection--reqpired:.6es----,'No
When corrections have been made, call for re-insppf tion at 303-234453
Date:- (-- �- - ' ' Inspector:
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
_1�9rBuilding Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: / �y r
Job Address: �� �� �� 1_516S19M
Permit Number: 0 `�c 2-6
,
Cr fj-; - v -
G
❑ No one available for inspection: Time AM/PM
Re -Inspection required: Yes No
*kVhen corrections have been made, call for re-inF
ion at 303-234-5933
�//_v
Date: Inspector: '
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: F -; t, A )
Job Address: L/ 14 qC-
Permit Number: 'a 0 17 0 a -7$
F_i 1M,,j �dIP�U'ad
PIet�reS ��Ccn ®� Ven
r) or �c W)C-*re /t a! e h Q 11
E' a va 4, o n S_ -X n r_ o M /�i a 1, 0,,tv
r -t a� ✓ e n 4-6 'f % c rr S
❑ No one available for inspection: Time `r= u C_
Re -Inspection required: Yes No
When corrections have been made, call for re -inspection at 303-234-5933
Date: 'a a 5— Inspector: iD
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
_��9rBuilding Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
j
Inspection Type: / 1 0
Job Address: L/ C/ C��� /j /_� SAS S
PermitNumber:
/ %,117V' r) L 1 / < < Cx V fIVZ C / D
❑ No one available for inspection: Time,) e/() AM/PM
Re -Inspection required: Yes No
When corrections have been made, call for re-inspe tion at 303-234-5933
r
Date: Lf" / % Inspector:}
DO NOT REMOVE THIS NOTICE
ibffbom 'S* * U 1 OJO J 42,W
INSPECTION RECORD °ccupancv/'IYbe
t�Vku INSPECTION REQUEST LINE: (303) 2345933
Inspections will not be performed unless this card is posted on the project site.
Call the inspection request line before 11:59 p.m. to receive an inspection the following business day.**
Inspector Must Sign ALL Spaces pertinent to this project
Foundation Inspections Date Inspector Comments
Initials
Pier
Concrete Encased Ground (CEG)
Foundation / P.E. Letter
Do Not Pour Concrete Prior To Approval Of The Above Inspections
Underground/Slab Inspections
Date Inspector G
Initials
Electrical
C
Sewer Service
Plumbing
omments
Do Not Cover Underground or Below/In-Slab Work Prior To Approval Of The Above Inspections
Rough Inspections
Date
Inspector
Initials
C
Wall Sheathing
Mid -Roof
Lath / Wall Tie
Rough Electric '
Rough Plumbing/Gas Line
Rough Mechanical
Rough Framing
City c
89/16/
Insulation
Drywall Screw /Nail
Instal
Final Inspections Date Inspector
Initials
Final Electrical
Final Plumbing
Final Mechanical
Roof
Final Window / Doors
Final Building
Landscaping 8 Parking I Planning Dept.
ROW & Drainage / Public Works Dept.
Fire Inspection / Fire Protection Dist.
omments
f Wheat Ridge
2816 13:15 CDBA
1 38 gallon wa
CDA813314
EPSP 4495 Balsas ST
APDL/PERMIT NO: 281681428
;;-P IIEWT RECEIVED
VS / 3181
AUTH CODE: 308784
TOTAL
AhOUNT
19.58
AMOUNT
59.58
59.5@
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.
NOTE: All items must be completed and approved by Planning, Public ritorks, Fire and Building before a Certificate
of Occupancy is issued. Approval of the Final Building inspection does riot constitute authorization of occupancy.
'For low voltage permits - Please be sure that rough inspections an _ompleted from the Fire District and electrical low voltage
by the Building Division.
"For Inspection Time Window Requests - Please email ins tirr ,reguestCcDci wheatridpe.co.us by 8:00 A.M. the day of the
inspection with the property address in the subject line of the em, -A.
Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued
Protect This Card From The Weather
1� 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: r • F, a:
Job Address: L4 q 1� S_
Permit Number: & 01 (, O ) L) o) g
❑ No one available for inspection: Time/d, 3_9 AMlPM
Re -Inspection required: Yes No
*When corrections have been made, call for re -inspection at 303-234-5933
Date: Inspector: `
DO NOT REMOVE THIS NOTICE
SET/16/20164RI11:62 AM FAX No, P X62
`WIMP
Mailing Address,dMerent than property address)
Address:
City, State, Zip:
ti Optnt #
#tr
#added:# ,.
�» s
# f f
" x r
... MOT k
rrr+
City of'
FOR OFFICE USE ONLY
Date:
PlanlPennit #
02
�=1111111 Fill ill Ill I ll�lllqlplli illir Isa
0 zmmz��
Property Address: 4495 Balsam St Wheat Ridge, CO 80033
Prope�y Owner (pleg�e_ Phone: 303-910-02380 'M
Property Owner Email: not available
Address: Same as Above
Contractor,Thd at Home Services, Inc
Contractor E-mail Address: copermits9gmail.com
Electrical:
W.R, City License #
City License #
Plumbing:
■
Phone: 1-855-712-8899
Complete all information on BO7FH sides of this form
r NEW COMMERCIALUPGRADE
El NEW RESIDENTIAL STRUCTURE COMMERCIAL ROOFING
COMMERCIAL ADDITION RESIDENTIAL ROOFING
RESDENTIAL ADDITION WINDOW REPLACEMENT
COMMERCIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.)
E] RESIDENTIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc,)
MECHANICAL b 111•.i4 REPAIR REPLACEMENT
PLUMBING SYSTEM/APPLIANCE REPAIR
tll/ ♦• * REPLACMENT
ELECTRICAL SYSTEM/APPLIANCE
M•A s f1 4r REPLACEMENT
(DescribeOTHER "
(For ALL projects, please provide a detailed description of work to be performed, including current use of areas,
amount of materials to be used, etc.)
Replace ( I ) window, like for like in existing openings. U -value .32
Sq. FULF _ _.._...—_-.wwu...___.--__ ___.._.._ Btu's
Gallons
Amp _. A.� .._ _ ��......--- Squares _._._ _ . _... _._.� _e Other _.... �...�..�._._ . � �.��.._
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CITY OF WHEAT RIDOE
a
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80033 - (303-235-2855)
Suilding Numbet: 2 v - VM t 2.
MORWAIM
rropertyOwnec NI'Ck 4--roer'
perty Address: t44qS Rcits--n 6
Contractof Ucense No-
company.
Permit Fee: S
PlanReviewfee. S
Use Tax: S
Total Fee:
DESCR)PTION:
'r p M W144 ;r
company: Company: Company:
M