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HomeMy WebLinkAbout4465 Reed Street62-J&` "5( Z;� 0 f -7 e (�162 VY INSPECTION RECORD INSPECTION ONLINE FORM: http://www.ci.wheatridge.co.us/inspection INSPECTION REQUEST LINE: (303) 234-5933 OW/T, Inspections will not be performed unless this card is posted on the project site. **Request an inspection before 11:59 p.m. (midnight) to receive an inspection the following business day.** Inspector Must Sign ALL Spacespertinent to this project Foundation Inspections Date Inspector Com ents Initials Pier Concrete Encased Ground (CEG) -- Foundation / P.E. Letter Underground/Slab Inspections Date Inspector Comments Initials Comments Electrical 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. Sewer Service Plumbing Fire Inspection / Fire Protection Dist. -- -- —_ . VN■■M .,...0`1 ,,,,,,,1-,,,p„ rrv,n rnVr 1 v Hpprovai uT i ne Above Inspections Rough Inspections Date Inspector Comments Initials T- 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. ectrical umbing !Fina!lMechanical Roof Final Window/Doors Final Building NOTE: All items must be completed and approved by Planning, Public Works, Fire and Building before a Certificate of Occupancy is issued. Approval of the Final Building inspection does not constitute authorization of occupancy. *Fnr Inw vnit2nn nnrmifc _ DI-- k- -.— tk-. - .. ■.:-____.:___ .. _. nvni uic i 11U LMOUHa dllu CICGIUIGal IOW voilage by the Building Division. Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued Protect This Card From The Weather ti A a City of Wheat Ridge Residential Roofing PERMIT - 201704649 PERMIT NO: 201704649 ISSUED: 07./24/2017 JOB ADDRESS: 4465 Reed ST EXPIRES: 07/24/2018 JOB DESCRIPTION: Residential Re -roof to install Tamko Heritage Harvest Gold asphalt shingles with 33 sq. *** CONTACTS *** OWNER (303)234-1279 SANELLI CHERYL A SUB (303)360-0708 Curtis Boyd 017261 Academy Roofing, 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: 10,630.00 FEES Total Valuation 0.00 Use Tax 223.23PAID Permit Fee 220.15 ** TOTAL ** 443.38 _ ___j *** 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 - 201704649 PERMIT NO: 201704649 ISSUED: 07/24/2017 JOB ADDRESS: 4465 Reed ST EXPIRES: 07/24/2018 JOB DESCRIPTION: Residential Re—roof to install Tamko Heritage Harvest Gold asphalt shingles with 33 sq. I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the 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 a d that all work to be performed is disclosed in this document and/or its' companyf g approved plans and specifications. Signature of OWNER or CONTRAGZVR (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 maybe subject to a fee equal to one-half of the originalpermitfee. 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 Oficial and is not guaranteed. 4. No work of anmanner shall be performed that shall results in a changeof the natural flow of water without prior and specific approval. 5. The permit holdy er 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 issua�ce anti of t s `h be construed to be a permit for, or an approval of, an violation of any provision of any applicablan of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Dan Schultz From: no-reply@ci.wheatridge.co.us Sent: Thursday, July 13, 2017 3:35 PM To: Permits CommDev Subject: Online Form Submittal: Residential Roofing Permit Application Categories: Gina Residential Roofing Permit Application This application is exclusively for new permits for residential roofs and for licensed contractors only. This type of permit is ONLY being processed online --do not come to City Hall to submit an application in person. Permits are processed and issued in the order they are received and due to the volume of requests, time to process varies and is subject to change. YOU WILL BE CONTACTED WHEN YOUR PERMIT IS READY FOR PICK-UP AND WILL BE GIVEN A SPECIFIC DATE AND TIME WINDOW TO COMPLETE THE TRANSACTION. You will be notified if your contractor's license or insurance has expired, and you may update those documents at the time you are issued your permit. For all other requests: Homeowners wishing to obtain a roofing permit must apply for the permit in person at City Hall. Revisions to existing permits (for example, to add redecking) must be completed in person at City Hall. All other non -roofing permits must be completed in person at City Hall. The Building Division will be open from 7:30-10:30 a.m., Monday through Friday to process these types of requests. THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN REROOFING UNTIL PERMIT HAS BEEN ISSUED. Is this application for a Yes residential roof? How many dwelling units Single Family Home are on the property? PROPERTY INFORMATION Property Address Property Owner Name Property Owner Phone Number Property Owner Email Address 4465 Reed Street Cheryl Sanelli 303-234-1279 Field not completed. S 44�;- -sF- 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 Academy Roofing Inc Contractor's License 17261 Number (for the City of Wheat Ridge) Contractor Phone 303-360-0708 Number Contractor Email Address nwilson@academyroofinginc.com Retype Contractor Email Address DESCRIPTION OF WORK Are you re -decking the roof? Description of Roofing Material nwilson@academyroofinginc.com No T/O (1) LAYER, PITCH 4/12, 33SQ, TAMKO HERITAGE (HARVEST GOLD) Select Type of Material: Asphalt If "Other" is selected Field not completed. above, describe here: How many squares of the 33 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 33 " roofing material for this project Provide additional detail house & garage 4/12 here on the description of 2 work. (Is this for a house or garage? What is the roof pitch? Etc) Project Value (contract 10,630 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 Suzan Rose Boyd Email not displaying correctly? View it in your browser. .ACADEMY OFING INC. Customer Cheryl Sanelli Mobile: (303) 234-1279 Attn: Cheryl Sanelli Mobile: (303) 234-1279 3211 Yarrow St E -Mail: No Email 1610 JASPER STREET AURORA, CO 80011 PHONE: (303) 360.0708 FAX: (303) 3646053 Work Location 4465 Reed St Cheryl Sanelli Contact: Cheryl Sanelli Gist Z3 Estimate 45297 7/5/2017 Email: sales@academyroofinginc.com Web: www.academyroofinginc.com Mobile: (303) 234-1279 E -Mail: No Email ` Wheat Ridge, CO 80033 f 4465 Reed St \�f Wheat Ridge, CO 80033 _. cademy Roofing Inc. (hereinafter referred to as "Contractor) proposes to provide all materials, labor and equipment necessary to perform the following Ja the Job Location. Prices include all applicable sales taxes, clean-up and removal of roofing debris, (unless otherwise noted). Contractor shall hold in trust any payment received from Customer until Contractor has delivered roofing materials at the site or has performed a majority of the roofing work on Customer's property (refer to Terms & Conditions #1) . Estimated date of service to be determined upon Contractor receiving signed contract. • Estimator: Alan Wolpa Replacement Estimate Please check boxes be/ow and iota/. Description y Estimate Roofing: Asphalt Z Remove and haul away (1) layer of existing roofing. I C ID Replace damaged roof deck if necessary. Install Ice and water barrier at the eave line of the roof 24" inside the exterior wall per code. Install roof deck protection. o (1) layer of synthetic underlayment. Install metal around perimeter of roof. o 2" x 2" pre -painted steel drip edge at rakes. o 2" x 4" pre -painted steel drip edge at eaves. Install wind protection around the perimeter of the roof (starter strip). Install shingles and ail related accessory products per high wind application instructions. Replace vents and metal roof penetrations and paint to coordinate with roof color. Replace all wall flashings to meet applicable codes. Flash (1) swamp cooler. Clean gutter and downspouts. Perform final clean up. Reroof the hou & garage with Tamko Heritage laminated asphalt shingles, in the color HARVES 70LD. (Limited 30 Year Warranty) Notes: - House showed evidence of hail damage. Log SCEO 11 Send H/O Packet—, Permit price shall be added to the total bill once incurred. Supervisor Pail Copy of permit shall accompany final bill for insurance company to reimburse homeownerb Scheduling Satellite dish to be detached before start of project, and to be reset upon completion of rbu replacement. (Dish may need to be realigned by satellite provider following roof installation). - Academy Roofing will pick up trash and magnet sweep for nails every night before leaving the site. All property will be protected from debris during the entire roofing process. All work performed and materials used will meet or exceed current Building Code requirements. All roofs installed by Academy Roofing will undergo our quality assurance review prior to being scheduled for Building Department Inspection. - Price based on driveway/yard access for removal and loading of material (trailer, loading truck, roll -off, dumpster, etc.). $10,630.00 Page 1 of 4 Estimate: 45297 Low Slope Roofing: Base & Cap Sheet @ Patio Remove all layers of existing roofing. Replace damaged roof deck if necessary.* Install metal around perimeter of roof. o 2" x 2" pre -painted steel drip edge at rakes. o 2" x 4" pre -painted steel drip edge at eaves. Replace all wall, pipe and vent flashings to meet applicable codes. Install self adhering low slope base and cap roofing membrane. Included in Asphalt Price * If we discover damaged roof decking when the existing roofing is removed, we will document the condition, and replace the damaged roof decking at an additional $65 per 4' x 8' sheet of 7/16" OSB sheathing. Notes: - Due to a less than 2/12 roof pitch, low slope roofing material is required by code. Gutter: S" Primed or Pre -painted Steel Remove and haul away the existing gutter. $870.00] Install 5" 26 gauge primed or pre -painted steel ogee style gutter. ©n u>es� sloe o� hayse �,��11 dowers/°©u f 012 west sr�e 6f arae �fS Notes: - Price excludes underground drain or adaptors. (Adaptor pricing available upon request). - Price valid with reroof contract only. Standard installation includes: Hidden hangers on 24" centers. All gutter is seamless, except at corners. Mitre joints are jobsite fabricated and sealed with an approved sealant. May we place a yard sign on your property? [l Yes 0 No Total from items checked: $ p J� �' f'd� /Nn (J1W Page 2 of 4 Workmanship Warranty 5 years Estimate: 45297 Payment is due upon completion. Customer may withhold up to 10% of total invoice amount pending inspection by building official. All sums not paid when due shall earn interest at the rate of 1% per month until paid and contractor shall be entitled to recover all costs of collection, including attorney's fees, if contractor is not paid. The terms and conditions set forth on the following page are a part of this proposal. Roof price is figured using driveway access for uploading roofing materials and down loading all roofing debris. Price includes permits (unless otherwise noted). This Proposal expires thirty (30) days after the date stated above if not earlier accepted, revised or withdrawn. ACCEPTANCE The proposed prices, specification and terms and conditions are satisfactory and hereby accepted. You are authorized to proceed with this work. Payment will be made as indicated above. Property Owner is _ / is not _ intending to make payments from the proceeds of a property and casualty insurance policy. Alan Wolpa Accepting Our Proposal �1/& Date Acc ted Owner's Signature Check the item(s) on the proposal that you want us to perform. Select your roof/gutter type and color. Total the dollar amount at the bottom of the proposal for all the items you want us to perform. Sign and date the proposal. Email, fax, mail or drop off the signed proposal at our office. Selecting a Color Please indicate your product and color selection in the spaces at the bottom of this page. We will insert your job into our schedule based upon having your product and color selections for all items you are purchasing. We can assist you with choosing products/color in the following ways: 1. You may visit our showroom at 1610 Jasper St. in Aurora, where you can see a display of many types of materials and colors and pick up sample boards to take with you. 2. We can deliver sample boards to the location of your choice. 3. If you wish to see a home with a certain roof product/color, we can provide you a list of addresses where you can view the product/color. Scheduling Your Sob Your job will be scheduled when you provide your product and color selections. You will receive a call from our Operations Department within 2 weeks to give you your projected schedule date. A week before your job is scheduled to begin we will send you information to help you prepare for the work that we are going to perform. *If you choose a standard weight tile roof, you must hire an engineer to inspect your home for tile suitability and then send us their written report concerning the structural modifications necessary (if any) for tile roof installation. We cannot begin the roof without this letter. We can provide the name of a professional engineer if you desire. / Product: k Coior.5eiectionr �'V 6�t �<d r Product; color Se%tion: INO—%i Expert Installation — Innovative Solutions _-�� [BI! J- " 90 :ta �zB A!!t) Yalsft llv: Ai♦'si-1-a3 taz's +gg" K-3LJS CR+fi , �.: �'`'� �.."a Notion] RWivig %vwfu`dvs A'wxb a!s r� $iinf 6511 n$s�131eetisd C®eeepany Page 3 of 4 f A i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line r" (3 03) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Anq Job Address: EE 'ST-. Permit Number: 26 ❑ No one available for inspection: Time M Pfd Re -Inspection required: Yes (Ff No When corrections have been made, call for re -inspection at 303-234-5933 Date: 0 Inspector: DO NOT REMOVE THIS NOTICE 4, CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line w -� (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: 1 Job Address: S� Permit Number: ❑ No one available for inspectionG-Time e�l- � ANI%PM ) Re -Inspection required: Yesi, No f% When corrections have been made, call for re -inspection at 303-234-5599333 : � Date ~ / Q 4 Inspector: �C74/ DO NOT REMOVE THIS NOTICE INSPECTION RECORD Occ 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. INSPECTOR MUST SIGN ALL SPACES PERTAINING TO THIS J OB FOUNDATION INSPECTIONS DATE INSPECTOR INITIALS COMMENTS: 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 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 CONSTITUTEAUTHORIZATION OF A CERTIFICATE OF OCCUPANCY NOR PERMISSION FOR OCCUPANCY. Electrical Service Rough Electric Rough Plumbing Gas Piping - Rough Mechanical ABOVE INSPECTIONS TO BE SIGNED PRIOR TO PROCEEDING Framing Insulation Drywall Screw FINALS - Electrical Plumbing Mechanical Roof 17 � /CC` 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 CONSTITUTEAUTHORIZATION OF A CERTIFICATE OF OCCUPANCY NOR PERMISSION FOR OCCUPANCY. UCCUPANCY NOT PERMITTED UNTIL CERTIFICATE OF OCCUPANCY IS ISSUED PROTECT THIS CARD FROM THE WEATHER ♦ .. +� CITY OF WHEAT RIDGE Building Inspection Division (303) 234 -5933 Inspection line (303) 235 -2855 Office;' (303) 237 -5929 Fax INSPECTION NOTICE Inspection Type , 5 yx-L Raz " Job Address 4 M� S' 5'7° Permit Number 1160-1;2 A wa/Ep a No one available for inspection: Time AM/ Re- Inspection required: Yes — When corrections have been made, call for re- inspection at 303 - 234 -5933 ,. Date: /� .! Inspector: , � DO NOT REMOVE THIS NOTICE S: City of Wheat Ridge Residential Roofing PERMIT - 110032 PERMIT NO: 110032 ISSUED: 01/13/2011 JOB ADDRESS: 4465 REED ST EXPIRES: 01/13/2012 DESCRIPTION: Reroof 17 sqs with Tamko 30 yrshingles * ** CONTACTS * ** owner 303/477 -4382 Millie Rico sub 303/360 -0708 Curtis Boyd 01 -7261 Academy Roofing, Inc. ** PARCEL INFO ** ZONE CODE: UA SUBDIVISION: 0801 USE: UA BLOCK /LOT #: 0/ ** FEE SUMMARY ** Permit Fee ESTIMATED PROJECT VALUATION: 15,862.00 FEES 299.40 Total Valuation .00 Use Tax 285.52 ** TOTAL ** 584.92 J1 ° ' Conditions: 6 nails per shingle is required. Ice dam membrane is required from save 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 ntities named within this document as parties to the work to be performed and that all work to be performed is disclosed in iz rent and /or its' accompanying approved plans and specifications. Signature oQ OWNER or .4NTRACTOR (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 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. 6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field i pe ' n. Signature f C ( ' ef Building Offical Date INSPE ION 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. i !N - 360g� �OF WHEAtglo City of Wheat Ridge Building Division Date: m 7500 W. 29 Ave., Wheat Ridge, CO 80033 Office: 303 - 235 -2855 * Fax: 303 - 235 -2857 Plan #: ooLOano° Inspection Line: 303 - 234 -5933 Permit #: d" ` f`. Property Owner (please print): Co Phone: 3 - E/77-�/.3 F a Mailing Address: (if different than property address) Address: City, State, Zip: Building Permit Application Contractor License #: Phone: TAPI Electrical City License #: Company: Plumbing City License #: Company Mechanical City License #: Company: Exp. Date: Exp. Date: Exp. Date: Approval: Approval: Approval: Use of s ace descnptlon): _ tj Construction Value: $ �, rl /U ��1 S l✓I Q K- (as calculated P er the Buildin Valuation Data sheet) t S— �.. I ��j, _1 I Plan Review (due at time of submittal): $ Sq. Ft. /L.Ft added: Squares _� BTU's Gallons Amps OWNERICONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this permit application are accurate, and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record;. that all measurements shown, and allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance with the Wheat Ridge Building Code (I.B.C) and all other applicable Wheat Ridge Ordinances, for work under this permit. PiaR b ect to field inspection. CIRLCE ONE: (OWNER) (CONTRACTOR) or PERSONAL REPRES TA ER) (_ TRATOR) PRINT NAME: _ © V r A SIGNATURE: J ' I3