HomeMy WebLinkAbout4380 Pierson StreetCity of
Wheatjdge
COMMUNITY DEVELOPMENT
City of Wheat Ridge Municipal Building 7500 W. 29' Ave.
August 22, 2019
Don Grove
Subapros Holdings LLC
4380 Pierson Street
Wheat Ridge, CO 80033
Dear Property Owner:
Wheat Ridge, CO 80033-8001 P: 303.235.2846 F: 303.235.2857
The Wheat Ridge Community Development Department has the following information and
determinations about the property at 4380 Pierson Street. The property is Lot 17 of the Bar
Heights Subdivision and is PIN/Schedule No. 300043597. It is zoned Commercial -One (C-1) and
is a legally independent lot from the SubaPros main property at 11072 W. 40, Avenue. Therefore,
the property at 4380 Pierson Street may be sold separately as -is.
The City has determined that the property contains a single-family home built in 1958 and
renovated in 1971, per the Jefferson County Assessor. Although the property is zoned C-1, the
City has determined that the house is still a residential structure and therefore can be used as a
residence. This use is considered legal since the house and residential use existed prior to March
11, 1997. However, if the property were to be redeveloped the house demolished or converted
into a commercial use any new residential use would not be permitted.
Renovations of the house, either to upgrade the existing residential finishes or to convert into
commercial, require building permits which must be obtained through the Building Division.
Conversion to commercial use will require a change of use and a new Certificate of Occupancy
verifying that the building is for commercial use only.
Feel free to contact me at 303-235-2849 or scutlerAci.wheatridge.co.us if you have any questions.
Sincerely,
Scott Cutler
Planner II
cc: 4380 Pierson Street address file
www.ci.wheatridge. co.us
A,
,VERS1C(D
ROOFING SYSTEMS
VersiGard® EPDM/VersiF1eece® EPDM
MEMBRANE MATERIAL WARRANTY
3063910
Subject to the following terms and conditions, Versico, a division of Carlisle Construction Materials Incorporated, warrants to
the Buyer that the Versico membrane material (MEMBRANE) will not prematurely deteriorate to the point of failure because of
weathering for a period of fifteen (15) years for 45 -mil membrane or greater, twenty (20) years for 60 -rail membrane or greater,
or thirty (30) years for 90 -mil membrane from the date of sales if properly installed, maintained and used for the purpose for
which Versico intended.
If upon inspection by Versico, the Membrane shows premature deterioration because of weathering within the designated
warranty period stated herein, Versico's liability and Buyer's remedies are limited at Versico's option to the providing of
repair material for the original Membrane or credit to be applied towards the purchase of a new Membrane, the value of
these remedies being determined by Versico based upon the number of remaining months of the unexpired warranty used to
pro -rate at the current prices for the Membrane. The maximum pro -rated value allowed by Versico for repair or credit shall
not exceed the original Membrane purchase price.
To validate this warranty, the registration information Hurst be completed by the owner and mailed along with the copy of
the invoice clearly indicating the material purchased within 10 days after the date of sale. Buyer shall give Versico notice of
a claim under this warranty within thirty (30) days of discovering any premature deterioration of theinembrane. Any claim
under this warranty must lie made in writing within the designated warranty period from theFdateof sale and must include
a sample of the membrane for evaluation -and response at the owner's expense.
This warranty refers to the deck membrane material only. Flashings, adhesives and other accessories contained in a membrane
system are not covered by this or any other warranty, express or implied.
Versico shall not be responsible for the cleanliness or discoloration of the membrane material caused by environmental
conditions including, but not limited to, dirt, pollutants or biological agents.
Versico shall have no liability under any theory of law for any claims, repairs, restoration, or other damages including,
but not limited to, consequential or incidental damages relating directly or indirectly, to the presence of any irritants,
contaminants, vapors, fumes, molds, fungi, bacteria, spores, mycotoxins, or the like in the building or in the air, land or
water serving the building.
NO REPRESENTATIVE OF VERSICO HAS AUTHORITY TO MAKE ANY REPRESENTATIONS OR PROMISES EXCEPT AS STATED HEREIN.
VERSICO DOES NOT WARRANT PRODUCTS UTILIZED IN AN INSTALLATION, WHICH IT HAS NOT FURNISHED; AND SPECIFICALLY
DISCLAIMS LIABILITY, UNDER ANY THEORY OF LAW ARISING OUT OF THE INSTALLATION AND PERFORMANCE OF, OR DAMAGES
SUSTAINED BY OR CAUSED BY, PRODUCTS NOT FURNISHED BY VERSICO.
THERE ARE NO WARRANTIES EITHER EXPRESSED OR IMPLIED, INCLUDING THE IMPLIED WARRANTIES OF MERCHANTABILITY
AND FITNESS FOR A PARTICULAR PURPOSE, WHICH EXTEND BEYOND THE WARRANTIES CONTAINED IN THIS DOCUMENT. VERSICO
SHALL NOT BE LIABLE FOR ANY INCIDENTAL, CONSEQUENTIAL OR OTHER DAMAGE, INCLUDING BUT NOT LIMITED TO, LOSS OF
PROFITS OR DAMAGES TO A STRUCTURE OR ITS CONTENTS UNDER ANY THEORY OF LAW. THIS WARRANTY IS NOT TRANSFERABLE
OR ASSIGNABLE.
VERSICO VERSIGARD EPDM/VERSIFLEECE EPDM MEMBRANE MATERIAL WARRANTY
Detach here and return completed form along with it cop) of the bill of sale or im-oice lin• the membrane to:
VERSICO
P.O.Bo� � / /
P.O. Box 1289 •Carlisle, PA 17013 UA'I'I; OF SAl.li: J 2 -err
Attn: Warranty Services Department
13uilding Owner's Namc: N-_rC4 l6yi.fF d 7�IJAC.D �a�o✓E
Building Owner's Address: 13 to P1 CC5oN ST W]'FE+?T f PCs9, C-0 $v033
Address and Location of Building: y3W P1e,0_son.) 57, WltLv4T 04be.e, CD 8aa33
lluilding O%rner's 'lcicphunc rNumbcr: (3033 ) YZ y - f 9 (.'7 Contact: -7 /k mr
Date Project Completed: _ _ J uNE 30TH , Z.v1Q
Rooling Contractors Name:
Rooling Contractor's Address; HOyl 57 e.+OL S7 /7t1;1v11tF4e-, Ga gU;,1f—
Type of Membrane: `,ersiUard ITI)NI ❑4.)-rnil 54 60 -mil 075 -mil ❑90 -mil
VersiFleece t;PDDI ❑ 4.) -mil ❑ 60 -mil ❑ 90 -mil 30,63910
� (�
\Tarrant}" Requested: I5 -year 43-, till-, 73- or 90 -mil ' 2' O p 3 0,6 3 9 1 "O
q ❑ Size of Pro' Sq.Ft.
20 -)'ear lilt-, 73- or 90 -mil ❑
30 -)car 911 -mil ❑ 602039 06/15
CARE & MAINTENANCE INFORMATION
The following items of maintenance information are not complete or exhaustive but are recommended for
a single -ply roofing system.
1) Clogged drains should be avoided to insure equal load across your structure.
2) Ponding water that does not dry in 48 hours after a rain could cause damage to the roofing system.
(The building owner is responsible for installing roof drains that meet this requirement.
This includes new construction, reroofing, and structural distortion or sag requiring drain addition,
relocation, or addition of tapered insulation.)
3) Petroleum products, if allowed to stand on the membrane, will have an adverse effect and may degrade
the surface of the membrane. Keep all petroleum products off the membrane (solvents, greases, oils, or
any other liquid containing petroleum).
4) Kitchen waste should not be exhausted onto the roof surface. They could reduce the life of your roof.
5) Foot traffic should be kept to a minimum. Any areas which require normal maintenance during a
30 -day period should have walkways to and from, as well as in the work area.
6) Under no circumstances should roofing cements be used in conjunction with the membrane.
7) Areas such as counterflashings, curbs, and pipes should be kept sealed at all time?.
8) If a leak occurs, don't assume that it is the membrane. Leaks are often the result of curbs skylights,
hatches, metal work, or plumbing problems. Carefully survey the problem first.
9) If any new installation is required on your roof, contact your preferred roofing company for a
recommendation as to how the unit is to be tied in to your existing roof. New work should be
completed by an Authorized Versico Contractor familiar with membrane systems.
General maintenance trades working on your rooftop units, doing plumbing, welding, soldering, and other
work, must use care and protection or they will could damage your roof. This type of damage is the owner's
responsibility and not covered by the membrane warranty.
Versico
P.O. Box 1289
Carlisle, PA 17013'
1-800-992-7663
BUILDING VALUE
September 21, 2018
CORE CONTRACTORS
4501 LOGAN STREET
DENVER, CO 80216
us
Project: 4380 Pierson Street, Wheat Ridge, CO 80033
To Whom It May Concern:
This letter is to confirm that CORE CONTRACTORS in DENVER, CO is a Versico Authorized
Contractor.
If you should have any further questions, please feel free to contact me.
Sincerely,
Jeff Kelly
Regional Sales Manager
P.O. Box 1289 Carlisle, PA 17013 toH free f 300,992 7663 www.versico.com
CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office - (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: Q�- �' n d r ` 00-C
Job Address:
Permit Number: 7 01 70 (f .�
6
V
r
���-� o I�
❑ No one available for inspection: Time ?- 5 AM PM
Re -Inspection required: Yes l_/
When corrections have been made, call for re -inspection at 303-234-5933
Date: f -/! Inspector: t30n f.
DO NOT REMOVE THIS NOTICE
A i CITY OF WHEAT RIDGE
Vr
_��9�Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office o (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: 3 G � - M 'd
Job Address: L) 3 S O �) e c-sC r,
Permit Number: 'd o)-7 D It 3 3 c-/
3U
J
❑ No one available for inspection: Time %. 17 M/PM
Re -Inspection required: Yes OCO
When corrections have been made, call f inspection at 303-234-5933
Date: 41 19 1, /q Inspector:
DO NOT REMOVE THIS NOTICE
City of Wheat Ridge
Commercial Roofing PERMIT - 201709334
PERMIT NO: 201709334 ISSUED: 11/29/2017
JOB ADDRESS: 4380 Pierson ST EXPIRES: 11/29/2018
JOB DESCRIPTION: Commercial re -roof, pitch is 1/12 total number of squares is 27.
*** CONTACTS ***
OWNER (303)424-1967
KULA, PETER
SUB (303)295-2220
Tomas Wofram
110052 Core Contractors, Inc.
*** PARCEL INFO ***
ZONE CODE:
UA / Unassigned
USE: UA / Unassigned
SUBDIVISION CODE:
140 / Converted
Residences;
0 BLOCK/LOT#: 0 /
*** FEE SUMMARY ***
ESTIMATED
PROJECT VALUATION: 25,500.00
FEES
Total Valuation
0.00
Use Tax
535.50
Permit Fee
453.55
** TOTAL **
989.05
*** COMMENTS ***
*** CONDITIONS ***
In order to pass a final inspection on commercial elastomeric or similar type roofing, 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.
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 -roof inspections may be called in at the same time, 100 percent of the sheathing must
be complete and 25-75 percent of the midroof may be complete. Asphalt shingles are required
to be fastened to the roof deck with a minimum of 6 nails per shingle. 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.
PERMIT NO:
JOB ADDRESS:
JOB DESCRIPTION:
City of Wheat Ridge
Commercial Roofing PERMIT - 201709334
201709334
4380 Pierson ST
ISSUED: 11/29/2017
EXPIRES: 11/29/2018
Commercial re -roof, pitch is 1/12 total number of squares is 27.
I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications,
applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized
by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with
this��ppermit. I further attest that I am legally authorized to include all entities named within this document as parties to the work to be
pertorped and that all,work to be performed is disclosed in this document and/or it's' accompanying approved plans and specifications.
j -i"
Signature of OWNER or CONTRACTOR (Circle one) Date
I. This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is
subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures.
2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and
received prior to the date of expiration. An extension of no more than 180 days made -be granted at the discretion of the Chief Building
Official and may be subject to a fee equal to one-half of the 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 andspecific 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, an violation of any provision of any
applicable code or any .:fdinance 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.
City of
�Wheat Midge
MUNITy 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 FOR OFFICE USE ONLY I
Date: 1i / Z `%/ /-�-
Plan/Permit #moi 0'-;/-3
y
Plan Review Fee:
�4eV-
Building Permit Application
*** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. ***
Property Address:
Property Owner (please print): Vele-ai Phone:
Property Owner Email: be'(()v?�5li�v���;�.G�
Mailing Address: (if different than property address)
Address
City, State, Zip:
Arch itect/Engineer:
Architect/Engineer E-mail:
Phone:
Contractor: C L CO- Vg+7 4C+15""'
Contractors City License #: Phone:
Contractor E-mail Address: �V�,�12%lc�e�✓✓Gt Cr OGS , Ccis-k-1
Sub Contractors:
Electrical
W.R. City License #
Other City Licensed Sub:
City License #
Plumbing:
W.R. City License #
Other City Licensed Sub:
City License #
Mechanical:
W.R. City License #
Complete all information on BOTH sides of this form
COMMERCIAL ❑ RESIDENTIAL
Description of work: (Check all that apply)
❑ NEW COMMERCIAL STRUCTURE ELECTRICAL SERVICE UPGRADE
❑ NEW RESIDENTIAL STRUCTURE COMMERCIAL ROOFING
❑ COMMERCIAL ADDITION 9 RESIDENTIAL ROOFING
❑ RESDENTIAL ADDITION ❑ WINDOW REPLACEMENT
❑ COMMERCIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.)
❑ RESIDENTIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.)
❑ MECHANICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT
❑ PLUMBING SYSTEM/APPLIANCE REPAIR or REPLACMENT
❑ ELECTRICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT
❑ OTHER (Describe)
(For ALL projects, please provide a 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.)
Cc 4''1 voei✓L
6c
Sq. Ft./LF Btu's
Amps Squares
Gallons
Other
Project Value: (Contract value or the cost of all materials and labor included in the entire project)
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or
regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are
accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance
with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner
or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any
entity included on this application to list that entity on this application. I, the applicant for this building permit application, warrant the
truthfulness of the information provided on the application.
CIRCLE ONE: (OWNER) (CON CTOR) or AUTHORIZED REPRESENTAT of (OWNER)CONTRACTOR '
Signature (first and last name): DATE: I /
ZONING COMMMENTS:
Reviewer:
BUILDING DEPARTMENT COMMENTS:
Reviewer:
DEPARTMENT USE ONLY
OCCUPANCY CLASSIFICATION:
Building Division Valuation: $
a a v a
M o
c
ro oIIi ro ro eo
cl I W
D a a
v�
el
o�
v
W W�
a a
nOQ
n
T -4 rt O 7
N3 H O
o fD m n
G
eD
c 2 �a
nr
o
Wt;
ay rt
Q
a ro a
0 ori 00 of
OrQ
zs
01 A W N N
O 00 01 A OD :E `
W N
m a
N C
oo G
1
I
I S
01 A
o_ Oo
W N
m a
N C
oo G
d
m
0
r*�
o
�
a
< W
3 •'
O
C
O. O•
`
m
:,
of
fu
rr
d
m
0
r*�
o
�
a
rt
•p
`
n00
D�n
°m
y�
1
`
V` a
Y'
o
o
m
n
m
elLn
C
cr
cu
n
c
"
el
`�
m
:;
a,
C
CL
a
N
n
A
O
INSPECTION RECORD Occupancay
"V INSPECTION LINE: (303) 234 -5933
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.
T 7r' O < r In 07_1 - �t
INSPECTOR MUST SIGN ALL SPACES PERTAINING TO THIS JOB
FOUNDATION INSPECTIONS
DATE
INSPECTOR
INITIALS
CONVENTS:
Footings /Caissons
Stemwall / (CEG) Concrete
Encased Ground
Reinforcing or Monolithic
POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED
ROUGHS
Sheathing
Weatherproof / French Drain
Lath /Wall tie
Sewer Service Lines
Mid -Roof
Water Service Lines
f ,
Electrical Service
CONCRETE SLAB FLOOR
Electrical (Underground)
Plumbing (Underground)
Heating (Underground)
DO NOT
POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED
ROUGHS
Sheathing
Building Final
Lath /Wall tie
Fire Department
Mid -Roof
R.O.W & Drainage INSPECTIONS FOR PLANNING & ZONING, FIRE AND PUBLICE WORKS
Parking & Landscaping SHOULD BE CALLED AT LEAST ONE WEEK PRIOR TO FINAL INSPECTIONS.
""NOTE: ALL ITEMS MUST BE COMPLETED AND APPROVED BY PLANNING AND ZONING, BUILDING AND PUBLIC WORKS BEFORE A
CERTIFICATE OF OCCUPANCY IS ISSUED. FINAL INSPECTION BY THE BUILDING DIVISION DOES NOT CONSTITUTE AUTHORIZATION
OF A CERTIFICATE OF OCCUPANCY NOR PERMISSION FOR OCCUPANCY.
f ,
Electrical Service
Rough Electric
Rough Plumbing
I ,
Gas Piping
Rough Mechanical
Framing
Insulation
Drywall Screw
BE SIGNED PRIOR TO
FINALS
Electrical
Plumbing
Mechanical
Roof
�
Ags
Building Final
Fire Department
R.O.W & Drainage INSPECTIONS FOR PLANNING & ZONING, FIRE AND PUBLICE WORKS
Parking & Landscaping SHOULD BE CALLED AT LEAST ONE WEEK PRIOR TO FINAL INSPECTIONS.
""NOTE: ALL ITEMS MUST BE COMPLETED AND APPROVED BY PLANNING AND ZONING, BUILDING AND PUBLIC WORKS BEFORE A
CERTIFICATE OF OCCUPANCY IS ISSUED. FINAL INSPECTION BY THE BUILDING DIVISION DOES NOT CONSTITUTE AUTHORIZATION
OF A CERTIFICATE OF OCCUPANCY NOR PERMISSION FOR OCCUPANCY.
OCCUPANCY NOT PERMITTED UNTIL CERTIFICATE OF OCCUPANCY IS ISSUED
PROTECT THIS CARD FROM THE WEATHER
` ii i
V , CITY OF WHEAT RIDGE
Building Inspection Division
J/ (303) 234 -5933 Inspection line
(303) 235 -2855 Office ' (303) 237 -8929 Fax
INSPECTION NOTICE
Rea
Inspection Type 61-Al
Job Address V3V 1 6 ,1.FISo V 's7
Permit Number
n Mn nna avai1ah1A fnr insnecfinn Times AMPAA 3
City of Wheat Ridge
r40 00 or-
Residential Roofing PERMIT - 102774
PERMIT NO: 102774 ISSUED: 12/22/2010
JOB ADDRESS: 4380 PIERSON ST EXPIRES: 12/22/2011
DESCRIPTION: Reroof 25 sqs with 30 yr OC shingles and IB roofing(flat)
* ** CONTACTS * **
owner Western Hydro
sub 720/217 -6414 Mark Myers
10 -0349 Mark's Roofing & Gutter Serv.
** PARCEL INFO **
ZONE CODE: UA
SUBDIVISION: 0167
USE: UA
BLOCK /LOT #: 0/
** FEE SUMMARY ** ESTIMATED PROJECT VALUATION: 13,850.00
FEES
Permit Fee 267.70
Total Valuation .00
Use Tax 249 . 30 fa,CCJ�csl )r.
** TOTAL ** 517.00
Conditions:
6 nails per shingle is required. Ice dam membrane is required from eave edge to
2' inside exterior walls. Board sheathing with any gap greater than 1/2"
requires panel sheathing overlay on entire roof. Sheathing inspection is
required prior to covering. Contractor shall provide ladder for inspections.
Scheduled inspections that cannot be performed due to inclement weather must be
cancelled prior to 8:30 a.m. on the day of inspection or a re- inspection fee
will be assessed.
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 permit. I further attest that I am legally authorized to include all
entities named within this document as parties to the work to be performed and that all work to be performed is disclosed in
tocument and /or its',,,aGZsgpanying approved plans and specifications.
Signature of OWNER or CONTRACTOR lrcL%e 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 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 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.
G. 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 'ns ion.
Signatu o ief Building Offical Date
INSP CTION REQUEST LINE: (303)234 -5933 BUILDING OFFICE: (303)235 -2855
REQUESTS MUST BE MADE BY 3PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
purr #
Building 8 inspection Services Division
7500 W. 29 Ave., Wheat Ridge, CO 80033 Permit # 2
Office: 303 -235 -2855 * Fax` 303- 237 -8929
Inspection Line: 303 -234 -5933
Building Permit Application
Property �dagess. '`\ \ � •�'�L��� ��T'
Property Owner (please print) , a1"a'�o������� - Phone:
Mailing Address: (if different than property address)
Address:
City, State,
Contractors City License #: Phone:
Syli�Contr�cfiors
Electrical: Plumbing: Mechanical:
City License # City License # City License #
0- 'efibbor bi' -work
Contract Value: ;
Review Fee (due at time of submittal):
�✓ BTU's Gallons Amps Sq Ft. $
Squares l J
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby certify that the setback distances proposed by this permit . application are accurate and do not violate applicable ordinances,
rules or regulations . of the City. of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and
allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full
responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on
this application; that I am the legal owner or have been authorized by the legal owner of the property to perform the described work
and am also authorized by the legal owner of any entity included on this application to list that entity on this application. -
CIRCLEONE: (OWNER) (CONTRACTOR) or (AUTHO D REPRESENTATIVE) of (OWNER) (CONTRACTOR)
PRINT NAME: ��``� \�"�3�\,S SIGNATURE: DATE \�
a � t � s e 3 W ''�' ° .:, x:, ` * /rte!✓ 2 "
- �^ � s /l s .'' ct � ' f T ��' � " c n.✓�) 9 ' W � t5 N Y � 3 h i r �'�i /ha � �-
E / S p'% c��u.n4 �� /y -'��� 4r/ ! r l3 �i'b��N G �_' :+, m�!"'py'^,1e✓'`wby:� �` %b ✓� �� r5 a'lY F �� 4 '� � l
s �'' " � �e�BYyC� �' � � i �" �i1� � `' ,�! �„ . ✓ h l y , ",� �K � c�� r .' p `lam t^r-"i ^." `^�� �.� �v l � ��" i�-s
f yr Fi
,i 'r .^ l .+" C 1 ^% / /F °s .' a}v"' B � ° (' ,f. 54" r X➢ l yr
�, ReW @Were„ r u � �: �� "' "y �i �� �`rti�f, ✓'� �`���'�r�i i�``� a �s,;S� ; ,S y s .
- r � ' S ✓ `,- } ? � a rte'., v �d ,. .......,,� oY.. �.y r
ftRE �EPAt3TMEN`T^�i3 approved w) co�lnents �- d�s;ipprpvad fl nb revtewYequtrad Bldg Valuation $_
r