HomeMy WebLinkAbout4440 Teller Streeti CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 37-8929 Fax
10A
I PECTIOdrTICE
17-4-1
Inspection Type:
Job Address: a
Permit Number: i2t_�E�zl ro42-:3
N
❑ No one available for inspection: T.+me/O"3a/ AM/ M _
Re -Inspection required: Yes` No
f
When corrections have been mailer call for re -inspection at 303-234-5933
/f
Date: / G Inspector:�-
DO NOT REMOVE THIS NOTICE
City of Wheat Ridge
- a -
Residential Plumbing PERMIT - 201900123
PERMIT NO: 201900123 ISSUED: 01/22/2019
JOB ADDRESS: 4440 Teller St EXPIRES: 01/22/2020
JOB DESCRIPTION: Installation of gas line and venting for future gas insert and stove;
electrical outlet included; 35 ft total
*** CONTACTS ***
OWNER (803)466-4689 JENNINGS WILSON
SUB (303)466-4206 Greg Fanger & Kevin Fanger 017986 The Gas Connection
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 11854.00
FEES
Total Valuation 0.00
Use Tax 38.93
Permit Fee 74.10
** TOTAL ** 113.03
*** COMMENTS ***
*** CONDITIONS ***
All work shall comply 2012 International Codes, 2017 NEC (if applicable), and ordinances
adopted by the City of Wheat Ridge. Work is subject to field inspections.
1, by m 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 allentities named within this document as parties to the work to be
performed and that all w t b permed ' isclosed in this document and/or its' accompanying approved plans and specifications.
00.22 .
Signature of OHNE or CON OR (Circle one) Date
1. This permit was issued based on t e information provided in the pen -nit 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 obe ne-half of the original permit fee.
uired to be
3. If this requireneents, ferm it es and procea new dure for approval of any new permit.. Res ssuancuance of a new e orextension permit of expiired permiteq s is at he ssole discretion of
e standard
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 grantink�anp�e', mit shall not be construed to be a permit for, or an approval of, any violation of any provision of any
applicabl�c ,de gr any r 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' c)f
Wheat c
tucNAN-.-AUNii-} Div[l,0i1&AF it
Building & Inspection Services
7500 W. 2911 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: 1/011//l
Plan/Permit #� r� 0 aI_3
Plan Review Fee:
Building Permit Application
*** Complete all applicable highlighted areas on both sides of this form.
Incomplete applications may not be processed. ***
Property Address: 'LI l '-IV 7��lk/ l T
Property Owner (please print): Wt bOVA Jk ft oo n5 Phone: °� ^ L16 (0 - y�
Property Owner Email:
Tenant Name (Commercial Projects Only)
Property Owner Mailing Address: (if different than property address)
Address: c )O_N k DJ'�, &boU L
City, State, Zip:
Architect/Engineer:
Architect/Engineer E-mail:
Contractor Name:
Phone:
City of Wheat Ridge License #: O lL-V Phone: _�)C)'Sr q U L� - L(")- 0 Lp
Contractor E-mail Address: S dU �a� A, �� �_oV� V� L� l\(�li � ry)
For Plan Review Questions $ Comments (please print):
CONTACT NAME (please print): �i�Q11\SI v'�CJ� Phone:3
CONTACT EMAIL(p/ease print): .n V\P (' 0Y) - 'toyV1
Sub Contractors (Must provide Wheat Ridge License No & Signed Subcontractor Authorization form):
Electrical: 0 -AE --r Plumbing: Mechanical:
W.R. City License # �-� W.R. City License # W.R. City License #
Other City Licensed Sub: Other City Licensed Sub:
City License # City License #
i • y ` • •' • ! • • •
❑COMMERCIAL
®'RESIDENTIAL
Provide description of work: For ALL projects, provide a detailed description of work to be
performed, including current use of areas, proposed uses, square footage, existing condition and
proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc.
-F---Vcw G6lk� ob 1 6-1�s Ulu 3 Apj-c 9 �'U- 12 cF c.3 &Uc3 9 6LJI
&A(,tom V- s c�
c il-un o b IV o'&
Sq. FULF BTUs
Amps Squares For Solar: Kw
For Commercial Projects Only: Occupancy Type:
Occupancy Load:
Gallons
# of Panels Requires Structural
Construction Type:
Square Footage: _
Project Value: (Contract value or the cost of all materials and labor included in the entire project)
$ ! q5 LA P
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 enty on this application. I, the applicant for this building permit application, warrant the
truthfulness of the information provided on th4 plication.
CIRCLE ONE: (OWNER) (C(
Signature (first and last name): _
Printed Name:
ZONING COMMMENTS:
Reviewer:
BUILDING DEPARTMENT COMMENTS:
Reviewer:
PUBLIC WORKS COMMENTS:
Reviewer:
Lr (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR)
DATE: - 7 - t
OCCUPANCY CLASSIFICATION:
CONSTRUCTION TYPE:
Building Division Valuation:
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�.j INSPECTION RECORD Occupa:�c /Type
INSPECTION REQUEST LINE: (3031234-S,14
Inspections will not be performed unless this card is posted on the project site. L
74,�'�,
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 Concrptp Prinr Tn Annrnval r1f Thn Ake%,#^ L,�....,..a:,...,.
Underground/Slab Inspections
Date Inspector Comments
Initials
Electrical
Mid -Roof
Sewer Service
Plumbing
Rough Inspections Date
I Sheathing22' 7
_ __
Inspector
I 'tials
____ _ __- .r •-•wv��. 1117 riVlIV11J
Comments
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 a I'
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.
-- -- -----:+- r----••-- •--^�- -� �•..� uua vuy11—H Vll v110 QIG IIVIII UIC rlle U[Wfui ana eiecincai low voltage
by the Building Division.
For notification of your assigned inspection time window please email in_timerequest&ci.wheatridge.co.us by 8:00 A.M.
the day of the inspection with the property address in the subject line of the email. Time windows are assigned based on
inspection routing.
Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued
Protect This Card From The Weather
City of Wheat Ridge
Residential Roofing PERMIT - 201702116
'ERMIT NO: 201702116 ISSUED: 06/19/2017
"OB ADDRESS: 4440 Teller ST EXPIRES: 06/19/2018
OB DESCRIPTION: Residential reroof: Install OC storm asphalt shingles, 27.66 squares house
5/12 pitch, tearing off 1 layer.
** CONTACTS ***
)WNER (720)785-0095 DICKINSON BRIAN
)UB (303)756-4400 Arik Connell/Chad Lidtke 090152 Connell's Custom Exterior Inc
** PARCEL INFO ***
,ONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 /
k** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 10,500.00
FEES
Cotal Valuation 0.00
Jse Tax 220.50
Permit Fee 220.15
k* TOTAL ** 440.65
*** 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 k/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€ms 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: /�_rb
Job Address: q y o %�' % lar Z5 -f
Permit Number: CY70 1(p
❑ No one available for inspection: Time
Re -Inspection required: Yes No
When corrections have been made, call for re -inspection at 303-234-5933
Dater(S?//7Inspector: )In4 l -1/j ' f__
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDQII�
Building Inspection (303) 234-5933 ��Inspectionqzzb
ie e
(303) 235-2855 Office • (303) 237-892 9 /
INSPECTION NOTICE
Inspection Type:
Job Address: T2
Permit Number:
❑ No one available for inspection: Time d, (�
- %"ViltIM7
Re -Inspection required: Yes
lf
When corrections have been made, call for re -inspection h 8t 03,2 4'S33
Date: Inspector: Al Gi�
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: Mo F
Job Address: ®-e Pw
Permit Number: :20f 7o 9 I
❑ No one available for inspection: Time
Re -Inspection required: Yes No
When corrections have been made, call for re -inspection at 303-234-5933
Date:bL,?ql 17
Inspector: C��--
DO NOT REMOVE THIS NOTICE
11 City of Wheat Ridge
3" Residential Roofing PERMIT - 201702116
PERMIT NO: 201702116 ISSUED: 06/19/2017
JOB ADDRESS: 4440 Teller ST EXPIRES: 06/19/2018
JOB DESCRIPTION: Residential reroof: Install OC storm asphalt shingles, 27.66 squares house
5/12 pitch, tearing off 1 layer.
*** CONTACTS ***
OWNER (720)785-0095 DICKINSON BRIAN
SUB (303)756-4400 Arik Connell/Chad Lidtke 090152 Connell's Custom Exterior Inc
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 10,500.00
FEES
Total Valuation 0.00
Use Tax 220.50
Permit Fee 220.15
** TOTAL ** 440.65
*** 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 Alh-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€ms 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.
City of Wheat Ridge
}F
Residential Roofing PERMIT - 201702116
A,
PERMIT NO: 201702116 ISSUED: 06/19/2017
JOB ADDRESS: 4440 Teller ST EXPIRES: 06/19/2018
JOB DESCRIPTION: Residential reroof: Install OC storm asphalt shingles, 27.66 squares house
5/12 pitch, tearing off 1 layer.
I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications,
applica le 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 amed within this document as parties to the work to be
perfed � _ ll work to be performed is disclosed in this document d./dor^its' ccompanying approved plans and specifications.
2.
nature of OWNERS CMTRACTOR (Circle one) Date
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.
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 andmay be subject to a fee equal to one-half of the original permit fee.
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.
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.
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.
The issuance or granting of a permit shall not be construed to be a permit for, or an ap�pproval of, any violation of any provision of any
applicable code or any ordinance or regulation of this jurisdiction. Approval of work` psubject 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.
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 I 0
From:
no-reply@ci.wheatridge.co.us
Sent:
Friday, June 9, 2017 10:44 AM
To:
Permits CommDev
Subject:
Online Form Submittal: Residential Roofing Permit Application
C1
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
City Hall. The Building Division
X,
person at 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.
4440 Teller Street
Brian Dickinson
720-785-0095
Field not completed.
Yes
CONTRACTOR INFORMATION
Contractor Name
Connell's Custom Exteriors, Inc.
Contractor's License
090152
Number (for the City of
Wheat Ridge)
Contractor Phone
3037564400
Number
Contractor Email Address
ccexteriors@comcast.net
(permit pick-up
instructions will be sent
to this email)
Retype Contractor Email
ccexteriors@comcast.net
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
OC Storm
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
no
on the flat roof?
TOTAL SQUARES of all
27.66
roofing material for this
proj ect
2
Provide additional detail
here on the description of
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)
Reroof house, 5/12 pitch, 1 layer tear off
10,500
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 Heather Connell
Email not displaying correctly? View it in your browser.
K
CONNELL'S
office and contact Information
CUSTOM EXTERIORS, INC.
hL
5303 E Evans Ave, Suite 306
Denver, CO 80222
Siding 0 Whldows
Office. 303-75644AD0
Fav 30-56-200
CCE Superior Craftsmanship
Wail: ceexleriers@mmeastnet
'Websile.
www.ceexteriors.com
Proposal Submitted To J-1 C, V1
Home Phone
Date
Address Ile i
Cell Phone -?'ZO 7 7,,,,-ln5uranceComparW
11Y - 11P
Work Phone
Policy
Sales Person
F- ir I' ell.
Phone
4;::—
Email Claim #
Y. 00(472 t.
Billing Address (if differ thonjoh address}
City, State, Zip
'St
_ty, at., Z.1
I
1qPF.r-MrATU')N'1Q
ROOFING:
Height: Pitch: Layers:
Shingle Brand:
Type: Color:
Owners' Initials:
Tear off Roofing (clean, haul debris & magnetize yard):
House L1 Garage 11 Others1rvl 0 Remove existing exhaust vents and seal off holes.
Install New Roofing:
-Install Shingle entire roof area including ridge cap.
--f 0- ft. of ice and water barrier on eaves. Install 15# Tar paper or 30# Tar paper,
�lnstall D -style drip edge on eaves and gable edges. Color: Owners' Initials:
Install roof vents. 0 Replace soil stack covers.
),Replace the following furnace pipe accessories -.4k Base flange Storm collar [1 China cap Closed cap.
A4nstall new vents: 11 Galvanized El Aluminum [I Turbine Vent 0 Ridge Vent
>Install new plumbing boots. El Install "W' valley- El Install rain diverters,
0 Dormer Flashing.XStep Flashing. A Gutter Apron.
SIDING:
Tear o -- idin clean, haul debris &I magaPAw9LL1z7=,e_ d)-
House 0 Other e El
'I Remove so t and fasci*
L _tj Remove gutters. EJ Remove downspouts.
stall New Sidin-:
0 Install us vraap Install fold Insulation
D In I new vent cover. 0 tall new siding co
. g Type: D Vin iding feel Siding El Hardboard Siding
Squares Profile Manufacturer Color O%mers' Initials
Install New Fascia: D Pre-bent
LF: Type: Color. Location: Size:
Type: 6 ion:
tall Alun'�'%Vrap:
-"�Ins �11A—Inminum W�., Tp
LF: Type: Color: Location: Size:
-Y Install New Seamless Aluminum Gutters and Downspouts:
LF: Color: Size: Location:
# of Downspouts: .a
SPECIAL INSTRUCTIONS:
6dj U14AA 4�
Deliver Instructions:
Owncrs2 Initials
CO2012-2
Colorado Insurance Agreemmil
CONNELLS Office and Contact Information
0 5303 E Evans Ave, Suite 306
0 CUSTOM EXTERIORS, INC.
Denver. CO KYP)
40
• Hoofing • Sidinc, • Windows 011im . 3 -756-41410
-
Fax. . X44W2,10
• Superior Craftsmanship
Email: r.ce.xIerior.0qJeomMsLne1
CC9=
11`ebsile: www.etexlertorscom
Proposal Submitted To
f2rca
Home Phone -
bate
I-1
Address 44LA 0 '1 e- kk er, S+^et-+
Cell Phone
Insurance Company
City, State- Zip SoWork
Phone
Policy #
Sales Person
Billing Address (IMfferentfromjab address)
City, State, Zip
I
Based on damages known po exist upon execution of this Agreement, the approximate cost to repair your home is
per shtk 614; ni dollars ($ —), which cost is subject to adjustment following the
Parties approval of the insurance company's authorized scope of repair.
F-009, &w -kr- ,
The approximate start date is The approximate completion date is (0 -
Delivery Instructions-
Z..p [.&-
-
PAYAIENT TERMS: THIS AGREEMENT IS SUBJECT TO THE PARTIES° APPROVAL OF INSURANCE COMPANY SCOPE, PRICING, AND
PAYMENT TERMS. Any insurer -approved supplemental work shall forma part of this Agreement. CONNELVS CUSTOM EXTERIORS, INC.
('CCE') shall be entitled to all direct cost overhead and profit paid by your insurer relating to work performed by CCE. All work requested
by you beyond that approved by your insurance company shall be your payment responsibility. This Agreement does not obligate you or
CCE in any way unless CCE accepts the scope, pricing, and payment, terms offered byyour insurance company. Unless otherwise provided
.in this Agreement, 50% of the price plus the insurance deductible is due upon final approval; balance due on completion.
Payment Information: Date: Check Number-. Amount:
ACCEPTANCE OF AGREEMENT
By signing this Agreement, you authorize Connell's Custom Exteriors, Inc. to discuss the damage to your real property with
your insurance company for the purpose of coming to an agreement: on project scope and price. Upon agreement by
Connell's Custom Exteriors, Inc. to the scope and price as defined on the insurance loss statement provided by your
insurance company, you authorize Connell's Custom Exteriors, Inc. to complete the replacement of said damaged property
with no-fttzAdft&iQ=1 - it to you except .far .-he mace der uctihfe subject to the terms and conditions on the reverse side.
Payments will be inade as outlined above. We will hold in trust any payment from you until we have delivered roofing materials to
your Property. This proposal must he accepted within thirty (30) days or it is automatically withdrawn. Terms an page 2
and on additional pages also form a part of this Agreement and are hereby accepted.
ACCEPTED
-5- 1-7
Date Owner Signature
'A U d7
ConLractor's ReTe 61-� OwnerSignature
In the event this Agreement was procured through a home solicitation sale as defined by Colorado Revised Statutes
Section 5-3-401., you may rescind your agreement. as set forth in the accompanying Notice of Cancellation. You, the
buyer, may cancel this purchase at any time prior to midnight of the third business day after the date of this
transaction. See attached Notice of Cancellation form for an explanation of this right In all other circumstances,
this Agreement is binding when signed by you and us.
002015
Cif cif
CommuNny DE VELOPMENT
Building Permit s ►
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♦ i CITY OF WHEAT RIDGE
r Building Inspection Division
1 (303) 234 -5933 Inspection line
_ (303) 235 -2855 Office • (303) 237 -8929 Fax
INSPECTION NOTICE
Inspection Type: SEl�4�xFiG
Job Address: VY(!o iFr
Permit Number: 1O ,11,97
s�- f�drJc i�
❑ No one available for inspection: Time 510 AM99�
Re- inspection required: Yes No
*When corrections have been made, call _ for / re - inspection at 303 - 234 - 5933
Date: �,S'f ✓19 Inspector: /.tee
DO NOT REMOVE THIS NOTICE
41 City of Wheat Ridge
1�
Homeowner Roof PERMIT - 102107
PERMIT NO: 102107
ISSUED:
09/07/2010
JOB ADDRESS: 4440 TELLER ST
EXPIRES:
09/07/2011
DESCRIPTION: Reroof 28 sqs with asphault
shingles
* ** CONTACTS * **
owner 720/276 -8880 Elton Rosas
** PARCEL INFO **
ZONE CODE: UA
USE:
UA
SUBDIVISION: 0009
BLOCK /LOT #:
0/
** FEE SUMMARY ** ESTIMATED
PROJECT VALUATION: 12,000.00
FEES
Permit Fee
236.00
� -=- r.
Total Valuation
.00
Y
E 6 �M-M t
Use Tax
216.00
7
L,s
'
** TOTAL **
452.00
Conditions:
I, the property owner, by my signature, attest that I currently reside at the
project property, intend to reside at the property for a period of one year
after completion of the project, and am personally performing all work, except
electrical, without the assistance of hired or professional workers.
Consultation and courtesy inspections will only be performed with the homeowner
of record.
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. Midroof inspection is not required on permits
purchased after 4/18/10. 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 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 Rid e ces, for work under this perms P ans subject to field inspection
contractor /owner
City of Wheat Ridge
_
Homeowner Roof PERMIT - 102107
PERMIT NO: 102107 ISSUED: 09/07/2010
JOB ADDRESS: 4440 TELLER ST EXPIRES:
DESCRIPTION: Reroof 28 sqs with asphault shingles
1. This permit was issued in accordance with the provisions set forth in your application and is subject to the laws of the
State of Colorado and to the Zoning Regulations and Building Codes of Wheat Ridge, Colorado or any other applicable
ordinances of the City.
2. This permit shall expire 150 days from the issue date. Requests for an extension must be received prior to expiration
date. An extension may be granted at the discretion of the Building Official.
3. If this permit expires, a new permit may be acquired for a fee of one -half the amount normally required, provided no
changes have been or will be made in the original plans and specifications and any suspension or abandonment has not
exceeded one (1) year. If changes have been or if suspension or abandonment exceeds one (1) year, full fees shall
be paid for a new permit.
4. No work of any manner shall be done that will change the natural flow of water causing a drainage problem.
5. Contractor shall notify the Building Inspector twenty -four (24) hours in advance for all inspections and shall receive
written approval on inspection card before proceeding with successive phases of the job.
6. The issuance of a permit or the approval of drawings and specifications shall not be construed to be a permit for, nor
an approval of, any violation of the provisions of the building codes or any other ordinance, law, rule or regulation.
All plan review is s ject to field inspections.
Signature of C lding Official date
INSPECTIO 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.
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Building Inspection Services Division
7500 W. 29" Ave., Wheat Ridge, CO 80033
Office: 303 -235- 2855 * Fax: 303- 237 -8929
Inspection Line: 303 - 234 -5933
Building Perrnit Application
Prt>grerty "Address; Z 1�l�D 7 e lle 5(— /
Property Owner (please print): 4 S15- !__Phone: 72Q 27rS - s8�
Mailing Address: (if different than property address)
Address:
City, State, Zip;
Contractors City License #: Phone:
Suls�ontrac4gr�a � _'
Electrical: Plumbing: Mechanical:
City License # City License # City License #,
Contract Value
$ fZ 000
Review Fee (due at ofsubmittaq:
Squares � BTU's Gallons Amps Sq Ft. $
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
1 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 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 1 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: (OWN ) (CONTRACTOR) or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR)
PRINT NAME: L/17ywt ,eO SIGNATURE:
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