HomeMy WebLinkAbout4315 Oak Street1* � � i City of Wheat Ridge
�� Residential Electric PERMIT - 202100489
PERMIT NO: 202100489 ISSUED: 03/11/2021
JOB ADDRESS: 4315 Oak St EXPIRES: 03/11/2022
JOB DESCRIPTION: Electrical service upgrade - 200 amps, rewire entire house
*** CONTACTS ***
OWNER (3 0 3) 929-5771 BERGREN JOSEPH
SUB (303)681-6600 SLAVA STAMPHER 180131 S STAR ELECTRIC, LTD
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2408 / FRUITDALE, LEES, STONERIDGE BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 10,000.00
FEES
Total Valuation 0.00
Use Tax 210.00
Permit Fee 204.30
** TOTAL ** 414.30
*** COMMENTS ***
*** CONDITIONS ***
Must comply w/ 2018 IRC & 2020 NEC . Subject to field inspection.
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�permrt. I further attest that I am leg ally authorized to include alI entities named within this document as parties to the work to be
performed and that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications.
Signature of OWNER or CONTRACTOR (Circle one) Date
1, This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is
subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures.
2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and
received prior to the date of expiration. An extension of no more than 180, days made be granted at the discretion of the Chief Building
Official and may be subject to a fee equal to one-half of the 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 requ�ired
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, anviolation of any provision of any
�pplicabje code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection.
03/11/2021
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
From: no-reolv(alci.wheatridae.m. us
To: CommDev Pets
Subject: Online Form Submittal: Electrical Service Change/Upgrade/Electrical Work Permit Application
Date: Thursday, March 11, 20218:30:40 AM
Electrical Service Change/Upgrade/Electrical Work Permit
Application
This application is exclusively for RESIDENTIAL ELECTRICAL SERVICE
CHANGE OR UPGRADE (200 amps or less).
YOU MUST ATTACH A VALID CREDIT CARD AUTHORIZATION FORM IN
ORDER FOR THE PERMIT TO BE PROCESSED.
Your Permit will be emailed to the email address provided below once it is
processed.
THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN
WORK UNTIL PERMIT HAS BEEN ISSUED.
Is this application for Yes
electrical service
change or upgrade -
200 amps or less?
PROPERTY INFORMATION
Is this Residential or Residential
Commercial?
Property Address 4315 Oak Street Wheat Ridge 80033
Property Owner Name Joseph Bergren
Property Owner Phone 303-929-5771
Number (enter WITH
dashes, eg 303-123-
4567)
Attach City of Wheat
Ridge Electronic
Payment Form - "DO
NOT ATTACH A
PICTURE OF A
CREDIT CARD"
CONTRACTOR INFORMATION
Contractor Business S Star Electric
Name
Contractor's License
180131
Number (This is a 5 or
6 digit number for the
City of Wheat Ridge)
Contractor Phone
303-681-6600
Number (enter WITH
dashes, eg 303-123-
4567)
Contractor Email
info@sstarelectric.com
Address
Retype Contractor
info@sstarelectric.com
Email Address
DESCRIPTION OF WORK
Is this an electrical
Upgrade
service upgrade or
change?
Number of Amps
200
Location of work
house
(garage, house, etc)
Provide additional
Whole house rewire and 200 AMP panel upgrade.
details, if needed.
Project Value (contract
10,000
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 work Yes
may not begin on this
property until a permit
has been issued and
posted on the property.
I certify that I have Yes
been authorized by the
legal owner of the
property to submit this
application and to
perform the work
described above.
I attest that everything Yes
stated in this
application is true and
correct and that
falsifying information in
this application is an
act of fraud and may
be punishable by fine,
imprisonment, or both.
Person Applying for Slava Stampher
Permit
Email not displaying correctly? View it in your browser.
City of Wheat Ridge
Residential Electric PERMIT - 202000058
PERMIT NO: 202000058 ISSUED: 01/08/2020
JOB ADDRESS: 4315 Oak St EXPIRES: 01/07/2021
JOB DESCRIPTION: Service upgrade - 200 amps
**REVISION: Entire house re -wire and smoke detector install. Added
valuation: $5750
*** CONTACTS ***
OWNER (303)929-5771 BERGREN JOSEPH
SUB (303)681-6600 SLAVA STAMPHER 180131 S STAR ELECTRIC, LTD
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2408 / FRUITDALE, LEES, STONERIDGE BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 8,000.00
FEES
Total Valuation 0.00
Use Tax 168.00
Permit Fee 172.60
** TOTAL ** 340.60
*** COMMENTS ***
*** CONDITIONS ***
Must comply w/ 2012 IRC & 2017 NEC. Subject to field inspection.
I, 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 furth r att9st that I legally authorized to include all entities named within this document as parties to the work to be
pert o ed and the al rk to be er o ed is disclosed in this document and/or its' accompanying approved plans and specifications.
1
Sig A at re of OWNER or CONTRACTOR (Circle one) Date
1. This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is
subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures.
2. This. permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and
received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building
Official and may be subject to a fee equal to one-half of the originalpermit fee.
3. if this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard
requirements, fees androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of
the Chief Building Official and is not guaranteed.
4. No work of any manner shall be performed that shall results in a change. of the natural flow of water without prior and specific approval.
5, The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all 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 an 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 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
City o('
Wheat fkeg
—j--COMMUNITY
DEVELOPMET
Building & Inspection Services Division
7500 W. 291 Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933
Email: permits(cDci.wheatridge.coms
FOR OFFICE USE ONLY
Date:
0����a
Add to Permit #
Building Permit Revision/Amendment Application
* Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. ***
Property Address: �� 0a 2 top P
� 4)
Property Owner
Mailing Address: (if different than property address)
Address:
City, State, Zip:
Submitting Corni2anys
Contact Person:\ci\��1f� Phone:
Contractor: S
Contractors City License #: Phone:
Contractor E-mail Address: C� C�)
Please Note: Additional valuation must include all general and subcontracted work to be performed
related to the revisions and/or amendments declared in the description of work and which were not
included in the original permit valuation.
If revisions or amendments increase the original valuation, additional fees will be due at the time of
approval. Depending on the scope of work, additional plan review fees may be due upon approval
($60.00 an hour — 2 hour minimum).
Description of revised/amended work:
�1�se vera, vt-b lwe.
Sq. Ft.ILF
Amps
Btu's
Squares
Gallons
Other
Additional Project \Value: (Must include all general and subcontracted work to be performed related to revisions/amendments described above)
$ V�� V
ON'NER/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.
CIRCLE ONE: (OWNER) (CONTRACTOR) or (AUTHORIZED REPRESENTATIVE)
PRINT NAME: iQ i0... SIGNATURE:
DEPARTMENT USE ONLY
ZONING COMMMENTS:
Reviewer
BUILDING DEPARTMENT COMMENTS:
Reviewer:
PUBLIC WORKS COMMENTS -
Reviewer
PROOF OF SUBMISSION FORMS
Fire Department ❑ Received ❑ Not Required
Water District ❑ Received ❑ Not Required
Sanitation District ❑ Received ❑ Not Required
of (OWNER) (CONTRA�CTOR)
DATE: 33 " 9,6
OCCUPANCY CLASSIFICATION:
Building Division Valuation: $
�1-
1* � 4 i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type: QA -6
Job Address:"'
Permit Number:
❑ No one available for inspection: Tim AM/PM
Re -Inspection required: Yes
When corrections have been made,
h ttp://www. ci. wheatridge. co. us/inspi
Date,• (C e,_>0_
for re -inspection online at:
i
FITS 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:
Job Address: L431 �i_
Permit Number: _jog
!
t i
❑ No one available for inspection: Time i k-`',0 AM/PM
Re -Inspection required: Yes No
When corrections have been made, call for re -inspection at 303-234-5933
Date: 1 " ,)1' 2..UZ0 Inspector:
DO NOT REMOVE THIS NOTICE
A i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 235-2855 Office
INSPECTION NOTICE
Inspection Type: e�.� f
Job Address: r�
Permit Number:
❑ No one available for inspection: Ti A pM
Re -Inspection required' Yes No
When corrections have been made, schedule for re -inspection online at:
http✓/www.ci.wheatridge.co.uslinspection )
Date
City of Wheat Ridge
-(.40gr Residential Electric PERMIT - 202000058
PERMIT NO: 202000058 ISSUED:
JOB ADDRESS: 4315 Oak St EXPIRES:
JOB DESCRIPTION: Service upgrade - 200 amps
*** CONTACTS ***
OWNER (303)929-5771 BERGREN JOSEPH
SUB (303)681-6600 SLAVA STAMPHER
01/08/2020
01/07/2021
180131 S STAR ELECTRIC, LTD
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2408 / FRUITDALE, LEES, STONERIDGE BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 2,250.00
FEES
Total Valuation 0.00
Use Tax 47.25
Permit Fee 93.35
** TOTAL ** 140.60
*** COMMENTS ***
*** CONDITIONS ***
Must comply w/ 2012 IRC & 2017 NEC. Subject to field inspection.
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 at t that I am legally authorized to include all entities named within this document as parties to the work to be
performed and that all w k to be performed is disclosed in this document and/or its' companying approved plans and specifications.
Signature
1. This pe i
subject to the cor
2. This. permit shall
received prior to
Official and may
3. If this permit exp
4. No work of an m
5, The permit holder
inspections and sh
Division.
6. The issuance or i
applicable cqe �r
1-12 or C TRACTOR (Circle one) Date
;ued Bd n the information provided in the permit application and accompanying Flans and specifications and is
)liance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures.
xpire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and
e date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Budding
e subject to a fee equal to one-half of the original permit fee.
es, a new permit may be regmired to be obtained. Issuance of a new permit shall be subject to the standard
and procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of
Offiial and is not guaranteed.
inner shall be performed that shall results in a changeof the natural flow of water without prior and specific approval.
shall notify the Building and Inspection Services Division in accordance with established policy of all required
ill not proceed or conceal work without written approval of such work from the Building and Inspection Services
intingof a p it shall not be construed to be a permit for, or an approval of, any violation of any provision of any
4;ordina aor regulation of this jurisdiction. Approval of work is subject to field inspection. A011111_tr,
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
City of
W heat idle
COMMUNriY DEVELOPMENT
Building & Inspection Services
7500 W. 29th Ave., Wheat Ridge, CO 80033
Office: 303-235-2855' Fax: 303-237-8929
Inspection Line: 303-234-5933
Email: permits -ci.wheatddge.co.us
FOR OFFICE USE ONLY
Date:
Plan/Permit # OT ['005
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:
Owner (please
Property Owner Email:
,1'b C` )a\C
Tenant Name (Commercial Projects Only)
Property Owner Mailing Address: (if different than property address)
Address:
City, State, Zip:
Architect/Engineer E-mail:
Phone:
Phone:
Contractor Name: S C I _�Q.(`X l (,—
City
City of Wheat Ridge License #: 1 �� 1� 1 Phone: (C& - U(sb
Contractor E-mail Address:��� F '< Z ��C�x-c \erg) c . ca�
For Plan Review Questions & Comments (please print):
CONTACT NAME (please print): L�D4YU Phone: Lc)�)VUOUO
CONTACT EMAIL(plea se print): ,c 2
Sub Contractors (Must provide Wheat Ridge License No & Signed Subcontractor Authorization form):
Electrical: 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
❑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.
Sq. Ft./LF
BTUs
Gallons
Amps a66 Squares For Solar: KW # of Panels Requires Structural
For Commercial Projects Only: Occupancy Type: Construction Type:
Occupancy Load: Square Footage:
Project Value: (Contract value or the cost of all materials and labor included in the entire project)
\ , bbt)
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 Cita of Wheat Ridge or covenants, easements or restrictions of record; that all measurements show n and allegations made are
accurate; that I have read and agree to abide by all conditions printed on this application and that I assume frill 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 bN the legal owner of the property to perform the described work and am also authorized by the legal owner of airy
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 OAE: (0A'1 ER) (COA4CTOR) or (.4UTH0RIZED REPRF.SEVT.AT1l E) of (Old',\ER) (COJ"TRACTOR)
Signature (first and last name): D.�TE: \ - Q
Printed Name: , ) IQ '
ZONING COMMMENTS:
Reviewer:
BUILDING DEPARTMENT COMMENTS:
Reviewer:
PUBLIC WORKS COMMENTS:
Reviewer:
OCCUPANCY CLASSIFICATION:
CONSTRUCTION TYPE:
Building Division Valuation:
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
a
Inspection Type: ,r--,C\C ♦ t
Job Address: t,_'S 1`'a C(._ S
Permit Number: i
❑ No one available for inspection: Time `` ` AM/FRMI)
Re -Inspection required: Yes N19
When corrections have been made, call for re -inspection at 303-234-5933
Date: Inspector:-"�-`
j
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: L -;'P? r \, n ;,nr\e (' C\ (0�1_C\
Job Address: q7% lS' CrrC. Sir
Permit Number: 06 a-?,C)!Q-i
❑ No one available for inspection: Time ;f A'.MYPM
Re -Inspection required: Yes No
When corrections have been made, call for re -inspection at 303-234-5933
Date: A Inspector: b
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:! _�(� �r n
Job Address: ( 1 3 15�
Permit Number: ,--) V 11
❑ No one available for inspection: Time ' _. ; AM/PM
Re -Inspection required: 'Yes No
When corrections have been made, call for re -inspection at 303-234-5933
Date: 1i _7 t Inspector: i
DO NOT REMOVE THIS NOTICE
City of Wheat Ridge
Residential Plumbing PERMIT - 201803063
PERMIT NO: 201803063 ISSUED: 11/21/2018
JOB ADDRESS: 4315 Oak St EXPIRES: 11/21/2019
JOB DESCRIPTION: Repair and replace 55 ft long sewer service in front yard; dual sweep
cleanouts; replace water line in front yard from house to meter; 5 ft deep
*** CONTACTS ***
OWNER (303)929-5771 BERGREN JOE
SUB (303)519-0240 R. Andrew Russell 120161 The Elite Pipe MD
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2408 / FRUITDALE, LEES, STONERIDGE BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 5,900.00
FEES
Total Valuation 0.00
Use Tax 123.90
Permit Fee 140.90
** TOTAL ** 264.80
*** 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.
ALL sewer repair/replacements for which a permit is issued MUST be inspected by and receive
written approval from the City of Wheat Ridge BUILDING DIVISION, regardless of inspection
by any Sanitation District representative. Inspection and approval of work by any
Sanitation District representative DOES NOT grant authority to cover work without the
approval of the Building Division.
**For trenchless sewer replacements - The contractor will verify proper slope of new sewer
piping in conformance with the IRC and IPC of 1/4 inch per foot unless otherwise allowed
specifically by the applicable code. The plumbing contractor will provide verification of
proper slope and drainage in writing as a condition of approval of the permitted work.**
City of Wheat Ridge
Residential Plumbing PERMIT - 201803063
PERMIT NO: 201803063 ISSUED: 11/21/2018
JOB ADDRESS: 4315 Oak St EXPIRES: 11/21/2019
JOB DESCRIPTION: Repair and replace 55 ft long sewer service in front yard; dual sweep
cleanouts; replace water line in front yard from house to meter; 5 ft deep
I, by ru 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
thispermit. 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 this document and/or its' accompanying approved plans and specifications.
/(/Z(
Signature of OWNER o CONTR f_TjDR--Circle onej Date
I. This permit was issued base 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 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 andspecific approval.
5. The permit holder shall notify the Building and Inspection Services D vision 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 oroipance 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
W heat R _ge
,40_7 DEVELOPMENT
Building & Inspection Services
7500 W. 29t' Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933
Email: permits()ci.wheatridge.co.us
FOR OFFICE USE ONLY
Date:
Plan/Permit #
Plan Review Fee:
Building Permit Application
*** Complete all applicable highlighted areas on both sides of this form.
Incomplete applications may not be processed. ***
G
Property Address: I �'3 j Jr 0 O K S}� � Kee, k (/'' A
Owner
Property Owner Email:
C' Ue(-cgt"C,"\
Tenant Name (Commercial Projects Only)
Phone: 3 q M _'5
Property Owner Mailing Address: (if different than property address)
Address: Al/ 1A
City, State, Zip:
Architect/Engineer E-mail:
Contractor Name:
City of Wheat Ridge License #:
IW(6l
Np
Phone:
Phone:
Contractor E-mail Address: K+1 U y 8 I e-, M 4� • 60✓/\
For Plan Review Questions & Comments (please print):
j
CONTACT NAME (please print): ` o L) i c 6n t v' c'`^e Z Phone: -7 1� 3'8 l
CONTACT EMAIL(p/ease print): daui d Qe t' V?; DeYV1J_. 6v,.v%
Sub Contractors (Must provide Wheat Ridge License No & Signed Subcontractor Authorization form):
Electrical: 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 #
Complete all highlighted fields, if applicable.
❑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.
5J�✓�� �rUvn �f (i�G ; t<:,
(l Uc-\ �5w
�7ro VIA
Sq. FULF
h u�� 0 5'0eZf
BTUs
Gallons
Amps Squares For Solar: KW # of Panels Requires Structural
For Commercial Projects Only: Occupancy Type: Construction Type:
Occupancy Load: Square Footage:
Project Value: (Contract value or the cost of all materials and labor included in the entire project)
$ '5C400
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) (CONTRACTOR) or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR)
Signature (first and last name): DATE: 1 1
Printed Name:�UJ i G
Z/G t U % C' 7
ZONING COMMMENTS:
Reviewer:
BUILDING DEPARTMENT COMMENTS:
Reviewer:
PUBLIC WORKS COMMENTS:
Reviewer:
DEPARTMENT USE ONLY
OCCUPANCY CLASSIFICATION:
CONSTRUCTION TYPE:
Building Division Valuation:
f~✓°~, City of Wheat Ridge
Residential
Fence PERNIIT - 070336
PSRMZT ffiQ:.- 070336. .
.
ISSUED: 04/18/2007
fiXPIRES: 10/15/2007
JOH i 4315 OAK ST
pggCgitt`iTqN: 6' privacy fence to
run from front
corners of house to side
#"(7'~'t'ACTS *•r. .
.
ownet ` 203/422-1527 Stuart A.
Adams
* * ~+Ad'~C~1+ TNFO
USE: R-3
ZONS,L'QLiS:,. A-1
BLOCK/LOT#: 0I
5~~~~ION, UA
ESTIMATED
PROJECT VALUATION: 200.00
FEES
PC,xt~lik.2+'CC .
30.55
7J
Total Ya,:Luation
"
•00
3.60
pleaseNote:
tor is :cspnnsible for locating ProFeTtY
t
Us$ TgLx
,
.
~
34.15
rac
pwner / con
tines and ccr.struc4iag imgroveme:1L^ xcor4ing to the
. *
l -,,......,,.,a~...~e
The City is not respousible for maccurate iuotmafion
Comttlattt8 :
submitted witlun the plan set and anS' construcfloa
ma~,
pK,~r' plan. FBnce cannot exceed 6' in height. errots ttml~DS from inaccvtate icfo
~
q peslby.ctl`tKiEy that the eeCback dietancee propoeed by thie pexmit applicatlon are accuzate, and do not violate applicable
pyd;;iaiiCeg, iulee or.regulaiioae of the City of Wheat Ridge or covenante, eaeemente or reatrictione of record; thatall
~yqnF,4^.shown, and allegatione made are accurate; tnat I have read and agree to abide by all conditiona printed on ehis
dpp1*e9 ~ C'~OS?`end that i aeeume full reeponeibility for compliance with the wheat A1dge eullQing Code (I.H.C) and all othes
gpy#4q*YC~4Wrieat Ridge Otdinancee, for work under thle pe:mit. Plana aubject to field inepection.
f o... 'Y.d'107
date
1:~....
3; ,
wae Seeued in aecocdance with the provieione eet forth in your applicaCion and Se eubject to the lawe of the
lorado and to the Zoning Regulationa and Building Codee of Nheat Rid9e, Colorado.or any other applicable
of the City.
shall expire 180 daye from the ieeue date. Requeete Eor an extenaion muat be received prior to espirat on
xtenslon may be 9ranted at the diecretion of the Building Official.
mSt expires, anew penmit may be acquired for a fee of one-half the amount normally zequlred, provided no has ,e been os will be made in the original plane and epecificatione and any euepeneion or aba~udi~ ea ehall c
ie (1) year. If changee have been or Sf euepeneion or abanQOnment exceede one (1) year,
r a new permit.
any manner ehall be done that will change the natural flow of water caueing a dzaina9e problem.
ehall notify the Building Inepector twenty-four (24) houre in advance for all inepectione and aHall receive
proval on inepection card before proceeding with eucceeaive phaeee of the job.
•e of a permit ox the approval of drawinge and epecificatlone ehall not be conetrued to be a pex*nit for, nor
f, any vSOla+tion of the provieiona of the building codee or any other ordinance, law, rule or re9ulation.
Wiew ie sy0jec.to field inapection9. 19996i'swe date
T LINB= (303)234-5933 BUZLDING OFFICE: (303)235-2855MADE BY 3PM ANY BUSZNESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
,;r
!TY DEVELOPMENT DEPARTMENT Permit Number:
Building
BUIIDING IN3PECTION U€,s C-..
'4j1g,\ CITY OF WHEAT RID~',E
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80033 - (303-235-2855)
W APPLICATION
Properiy Owner: Stuart A.Adams
Property Address: 4315 Oak st. Wheatridge Co. 80033
t'hone:
303-422-1527
Cor,:
Company:
Phone:
ONMERICONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT Bulidina Deat. Valuat/on Flgaie: $ .
I herotry certiry that Me aetbadc distamxs propoxd by tha pemnR applicxfion aro
accurate, and do not violate epplicebla oMinencea, rules or regulatiorta of the City of \Ia(Ue: $
Wheat Ridge or covenants, easemaMs or reatriqiona of record; tha[ all rtreasuremeMs
sh~n, and allegations made are accurate; that I have read antl agree to abide by eU PCtiriit FEC:$
eonddions priMed on ihis application end ihat I assume (ull reaponsibility for
compiiancewlththoWheatRi~ BuildingCoda(i.B.C)andatlotherapplicableWtreat P1an ReviewFee:$
Ridge Ordinances, for work under this pertnd. Plans subjea ro field inspection. USC T3X:$@
;ONMERNCONTWICTOH):91GNEDg~~~~ 2_;DATE-~~[~ TO~:~p
(OWNER)(CONTRACTOR);PRINTED_STUART A. ADAMS _
TE 41&2007
Use of Space (description):_Fence
Description of work:
Sq. Ft, added
COMMEN7S:
Approval:
Zoning:
COMMENTS:
Approval:
IORKS COMMENTS:
Approval:
BUILDINC DEPARTMENT USE ONLY
DEPARTMEM COMMENTS:
Approval:
Walls: Roof: Stories: Residential Units:
Electrical License No: Plumbing License No: Mechanical License No:
Company: Company: Company:
Expiration Date: Expiration Date: Expiration Date:
Approval: Approval: Approval:
(1) This permit was issued in accoMance with the provisions set forth in your epplication and is subjad to the lawa of tha State of
Colorado and to the Zoning Regulations and Buildirg Codea of Wheat Ridge, Colorado or eny dher applicable ordinances of
the Cdy.
(2) This permil shall expire 'rf (A) the work authorized is not commenced within sixty (90) days from issue date or (8) the building
autMtized is suspanded or abandoned for a poriod of 180 days.
(3) If this pertnR expires, a new permft may be acquired for a fee of one-AaM fhe amouM normally required, provided no changes
have been or will be made in the origlnal plens and specificeHons and any suspension or abandonmeM has not exceetled orre
(1) year, If cherges have been or ff auapension or abantlonmaM excoada orro (1) year, fuN 4eea shall De paid Wr a rrew permrt.
(4) No woric of any manner ahall be done lhat will change the natural flow of water causing a drainage problem.
(5) Contraclor shall noiify the BuiMing Intpector twenty•four (24) hours in atlvance for all inspections and shall receive wriHen
~
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Please No
Otvncr/coat-°c•__,,
lincs and cc.
aPProved p.an an.' .
'ILe City is not responsible for
submitted wit6in the plan set
erron resulting from inacc
r lo afing ProF-rtY
- - i^r;'srg to the
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~
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~L laboratorla lec.< ~ # \ t 7 c1 ► 3
TGAH.GuideInfo
Prepared Roof Covering Materials, Asphalt Shingle Wind Resistance
View Listings Paee Bottom
4uestions? Previous Page
[Roof Covering Materials] Prepared Roof Covering Materials,
Asphalt Shingle Wind Resistance
-Guide I.nformation
GENERAL
This category covers the investigation of asphalt shingles surfaced with mineral granules which are designed to
resist wind forces by affixing the shingle above to the surface of the shingle below with a sealant (factory or
field applied) applied in a pattem aligned parallel to the windward edge of the shingle. The investigation
process involves three steps: 1) the determination by test of a wind uplift ccefficient, 2) the calculation of the
potential uplift force (Ibf) acting on the tab sealant, utilizing the wind uplift ccefficient and specific wind speed
selected for the investigation and 3) the deterniination of resistance force (Ibf) capability of the tab sealant as
determined by mechanical test.
Wind Uplift Force Requirements
NlW%e wind uplift coefficient is determined based on sir flow perpendicular to and across the shingle surface. The
'nd uplift coefficient is caiculated by measwing pressures above acid below the shingle surface at the
windward and leeward sides of the sealant. The uplift force (Ibf) acting on the sealant is then calculated to
correspond to the wind speed classifications as tabulated below:
` Class D - 90 mph
Class F - 110 mph
Class G - 120 mph
Class H - 150 mph
The wind uplift ccefficient is detennined and the corresponding uplift force (lbf) is calculated in accordance
with iJL 2390, "Test Method for Wind Resistant Asphalt Shingles with Sealed Tabs."
Tab Sealaot Uplift Resistance Requirements
The uplift resistance (lb fl capability is determined by ASTM D6381, "Standard Test Method for Measurement
of Asphalt Shingle Mechanical Uplift Resistance." The uplift resistance force detertnined from this mechanical
test method is equal to or greater than the calculated uplift force for the corresponding wind speed classification.
UNEVALUATED FACTORS
The effects of weathering on the wind resistance of these materials have not been invesrigated.
ADDTI'IONAL INFORMATION
For additional information, see Roof Covering Materials (TEVT) and Roofing Materials and Systems
(AARM).
REQUIItEMENTS
In order to be eligible for Classification under this category, asphalt shingles must also be Listed under Prepared
Roof Covering Materials T( FWZ).
The Classifications for uplift force are derived from tests conducted in accordance with LTI.2390, "Test Method
for Wind Resistant Asphalt Shingles with Sealed Tabs."
iTI. MARK
The Classification Mark of Underwriters Laboratories Inc. on the product or package of products is the only
method provided by iJL to identify products manufactured under its Classification and Follow-Up Service. The
Classification Mark for these products includes the Listing Mark for Prepared Roof Covering Materials
(TFyV_Z) and the statement:
ALSO CLASSIFIED AS TO UPLIFT RESISTANCE
CLASS +
Control No.
+D,FGorH
.
Page Top Notice of Disclaimer Questions. Previous Pa e
~ 1
UL Listed and Classified Products UL Recoenized Products Certified for
- om nents Canada
This page and ell contenis are Copyright C 2004 by Underwriters Laboratories Inc.(&
The appearance of a company's name or product in Uvs database does not in itself essure that products so identified have been
manufactined under IJL's Follow-Up Service. Only those products bearing the UL Mark should be considered to be Listed and
covered under iJL's Follow-Up Service. Always look for the Merk on the product.
UL peimits the reproduction of the material conteined in the Onlice Certification Directory subject to the following condilions: 1. The
Guide Infotmation, Designs and/or Listings (files) must be presented in their entirety end in a non-misleading manner, without any
manipuletion of the data (or drawings). 2. The statement "Reprinted from Ihe Online Certifications Directory with permission from
Underwnters Laboratories Inc." must appear edjacent to the extracted ma[erial. In eddition, the reprinted maleriel must include a
copynght notice in the foilowing format "Copyright (D 2004 Underwriteis Leboratories Inc.0"
PRODUCT SPECIFICATION - SUPREME@
Section 07311 Fiber glass-based Asphalt Shingles.
PART1-GENERAL ~
Related Sections
A. Rough Cazpentry Section 06100.
B. Roof and Deck Insulation Section 07240 for insulation placed over roof decking.
Notes to Specifier:
1. Underlayment and shingles instatled direcdy over roof insulation or similaz type decks
is not approved
2. Roof deck must be dry, minimum 25/32" thick, maximum 6" wide boazds, or APA
rated sheathing (exposure 1): minimum 3/8" PlyH,ood, minimum 7/16" oriented
strand board or waferboard, Consult your Owens Coming representative for other
approved constructions.
3. Ventilation under roof deck must meet FHA Minunum Property gtandards
C. Flashing and Sheet Metal: Section 07600. For snow guards, metal flashing and drip
edges, including step-type flashing installed with shingles.
D. Roof Accessories: Section 07800:
Accessories.
1. RAFT-R-MAT'EO iJLp Listed
2. Soffits
3. VentSure@ Ventilation Products
4. Hip & Ridge Shingles
5. WeatherLoclc8
. ~
~ A. ASTM D 224 -Standard Specification for Smooth-SurFaced Asphalt Roll Roofing.
B. ASTM D 226 -$tandard Specification for Asphalt-Saturated Organic Felt used in
Roofmg and Waterproofmg.
C. ASTM D 1970 - Standard Specification for Self-Adhering Polymer Modified
Bituminous Sheet Materials Used as Steep Roofmg Underlayment for Ice Dam
Protection.
D. ASTM D 3018 - Standard Specification for Class A Shingles Surfaced with Mineral
Granules.
E. ASTM D 3161- Standazd Test Method for Wind-Resistance of Asphalt Shingles
(Fan-Induced Method).
F. ASTM D 3462 - Standand SpeciFcation for Asphalt Shingles Made from Glass felt
and Surfaced with Mineial Granules.
G. ASTM D 4586 - Standard Specification for Asphalt Roof Cement, Asbestos -Free.
H. ASTM D 4869 - Standand Specification for Asphalt -Saturated Organic Felt Shingle
Underlayment Used in roofing.
1. ASTM D 6757 - Standard Specification for Inorganic Underlayment for Use with
Steep Slope Roofing
J. ASTM E 108 - Standard Test Methods for Fire Tests of Roof Coverings.
Quality Assurance A. Shingles shall carry Underwriter's Laboratories Labels:
1- •UL8 790, Class A Fire Resistance
2. IJLp 997, Wind Resistance
3. ASTM D3462
B. Install shingles to meet requiremenu of published Owens Coming instmctions.
it
PRODUCT SPECIFICATION - SUPREMES
PART 1 - GENERAL (Cont'd)
Submittals
A. Manufacturer color sample showing full tange of colors available for specified products.
B. Product literature and recommended installation procedures.
C. Owens Corning Limited Warranty
*
Delivery, Starage, and Handling
A. Deliver materials to site in manufacturer's unopened bundles with labels intact and
legible.
B. Handle and store materials on site to prevent damage. Store in a covered ventilated area
at a maximum temperature of 110°F.
C. Do not stack product more than 2 pallets high. ]f stacking 2 pallets high, use separator
boazds to protect the shingles below.
D. Roof Top Loading: Lay shingle bundles flat. Do not bend over the ridge.
Project Conditions
A. Proceed with installing shingles only when weather is appropriate for a quality
installation.
B. Do not install underlayment or shingles on wet surfaces.
Warranty
A. Materials: Owens Coming 25-year Limited Warranty* terms and conditions apply.
PRODUCT SPECIFICATION - SUPREME@
PART2-PRODUCTS
Asphalt Shingles
Owens Corning Supreme% fiber glass-based asphalt shingles complying with ASTM
specifications E 108 Class A or UL 790 Class A, D 3462, D 3161 or UL 997, D 3018 Type 1,
ICBO ES ER 5443, ASTM D 228.
Su reme@ Shin leFroductS eci uation
Nominal Size:
12" x 36"
E osure:
5"
Shin les r S uare:
80
Bundles er S uare:
3 bundles of 26 or 27 shin les
Covera e er S uare:
100 . ft.
Ventilation
Owens Corning VentSiueO Rigid Roll Ridge Vent with Weather PROtectorT", VentSure Rigid
Strip Ridge Vent, VentSu7e Roof vents, VentSureTM' Gable venu, VentSure Undereave vents,
VentSure Miniature venu, VentSure Foundation vents.
Waterproofing Underlayment
Owens Corning waterproofing underlayment "WeatherLocV' meets ASTM D 1970 self-adhesive
waterproofing underlayment, fiber glass reinforced with SBS modified asphalt, LJL Listed.
1. WeatherLockO Mat,
2. WeatherLock(B G
3. WeatherLoclc@ P
Asphalt Felt Underlayment
Non-perforated, [Type I, No. IS] [Type II, no. 30], asphalt saturated felt complying with ASTM
D 226, ASTM D 4869 or ASTM D 6757.
Hip & Ridge Shingles
Owens Corning Cut-Up Strip shingles of same background colar as field of roof.
PRODUCT SPECIFICATION - SUPREMES
PART 2 - PRODUCTS (ConNd)
Fasteners
All fasteners must be driven flush with ihe shingie surface and penetrate at least inro the wood deck. Where the
deck is less ihan thick, the fastener shauld be long enough to penetrate fulty and extend at least 1/8" ihrough
the roof deck.
Owens Coming recommends the use of nails as the preferred method of attaching shingles to
wood decking or other nailable substrates. If staples are used they must be, corrosion resistant, zinc-
coated, 16-gauge minimum with minimum 15/16" crown width. Staples must be long enough to
penetrate at least into solid decking, or extend a minimum of 1/8" through the APA-rated sheathing.
PRODUCT SPECIFICATION -SUPREME@
PART 3 - EXECUTION
Examination
Prior to starting work, examine all roof decks on which work is to be applied for defects in
materials and wotkmanship which may be detrimental to the proper installation or long-term
perFormance of the shingles.
Installation
Installation shall be in accordance with the Guide to Installing Asphalt Roofing Shingles
published by Owens Corning and your local building codes.
Product styles and colors change over titce, Cw cunent selenirn of products and colors in your uea, plcasc conhaa your Owrns
Comiug iepresenlative.
Owcns Coming ttrives to accuretely iepmduce the unaBes of shingles in this ]iteianue. Howcva, due to manufactudng
vadances, the limitation of graptuc rcpmduction and the variation in natural ezterior lighting, actual shingle colors, and gronule
blends may vary fiom the imaqes you see mproduced in this literehue. For ihis reason, it is wportant to see an xtuai roofing
sample or actual products inyyal7ed on a 6ome before niaking final color sdeaion.
Available in the following p7ant areas: Bmokville, Compton, Drnver, Houston,lrving, Medina, Memphis North, Minpeypolis,
Summit
• See actual waaanry fot mmplete details.
COMMUNITY DEVELOPMENT DEPARTMENT Building Permit Number : 77973
BUILDING INSPECTION LINE - (303-234-5933)
CITY OF WHEAT RIDGE Date : 10/19/2004
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80033 - (303-235-2855)
Property Owner: STUART ADAMS
Property Address : 4315 OAK STREET Phone : 3-422-1527
Contractor License No. : 17202
Company : Stahl Roofing, Inc. Phone : 2893500
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT ValuatiOn : $1,433.00
I hereby certify that the setback distances proposed by this permit application are accurate, and Permit Fee : $70.25
do not violate applicable ordinances, rules or regulations of the City of W heat Ridge or
covenants, easements or restrictions of record; that all measurements shown, and allegations Plan Review Fee : $0.00
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 compli giyce with the Wheat Ridge Building USB T8X : $17.20
Code (U.B.C.) and all other applicable W at4~g~ ord' ces, for work under this permit.
(OWNER)(CONTRACTOR)SIGNE DAT Total: $87.45
Use :CSU,r.t_ 7~. (33
Description : T/O 2 LAYERS OF ASPHALT SHINGLES, INSTALL NEW 20 YEAR 3-TAB SHINGLES
BUILDING DEPARTMENT USE ONLY ~
xoning Comrttents: SIC : Sq. Ft. :
Approval :
Zoning : Documents from the manuJ'acturer shall be I
guilding'Comri0nTts;` onstte for f:nal roof fnspection which spec6
roofmg materials have been installed to meet
Approval : 170 MPH three-s¢cond wtnd gust--IBC (90
Fublic wt~rks 4omments:' MPFI wind lond--LIBC):
Approval :
Occupancy : Walls : Roof : Stories : Residential Units :
Electrical License No :
Company:
Plumbing License No :
Company :
Mechanical License No :
Company :
Expiration Date :
Approval :
Expiration Date :
Approval:
Expiration Date :
Approval:
(1) This permit was issuetl in accortlance with the provisions set forth in yopur application and is subject ro the laws of ihe Stata of Coloretlo and to the Zoning
Regulations and Building Coda of Wheat Ridge, Colorado or any olher applicable ordinances of ihe City.
(2) This permit shall expire i( (A) the work authorized is not commenced within sixty (60) days from issue date or (B) the building authonzed is suspended or
abandoned for a period of 720 tlays. (3) If Ihis permit ezpires, a new permit may be acquired for a fee of one-half the amounl normally requiretl, provitled no changes have been or will be matle in the
original plans and specifcations and any suspension or abandonment has nat exceeded one (1) year. If changes are made or if suspension ar abandonment
exceeds one (1) year, fu0 fees shall be paid for a new pertnit.
(4) No work of any manner shali be done that will change the natural Flow of water causing a tlreinage problem.
(5) Conlrector shall noti(y the Building Inspeclor hvenry-(our (24) hours in advance for all inspedions and shall receive writlen approval on inspection card before
proceediing with successive phases of ihe job.
(6) The issuance it or ppmval oPtlrewings and specifcations shall not be construed to be a permit for, nor an approval of, any violation of the
provisi iltli ~ or an o cokinance, law, mle or regulation.
Chief Building Inspector
Please sign Terms and Conditions on reverse side of page.
DEPARTMENT OF PLANNING AND DEVELOPMENT Building Permit Number:
OF WHEqT
~ BUII,DING INSPECTION LI1VE - 303-234-5933 Date:
CITY OF WHEAT RIDGE
7500 WEST 29TH AVENLTE
WHEAT RIDGE, CO 80215 -(,3y03-235-2855)~v
f~PHi"~~d 3 tdN
ProperryOwner:7blOA-IJ'
ProperryAddress: 5/~'jSC~/'9KST. Phone//`
ContractorLicenseNo.:
- Company:S%41/ CJn F~n/4 Phone: -t<.i.
OWNER/CONTRACTpg SIGNAT[1RE OF UIYDERSTANDING AND AGREEMENT
I hereby certify fhat the setback distances proposed by,this petmit applicario¢ aze
accurate, md do not violaGe applicable ordinances, rufes or regulalions of the City of
Wheat Ridge or covenants, euements or restrictions of mcord; that afl meuumments
show¢, md allegations made arc accuraze; thaz I have read md agrec [o abide by a11
co¢ditions printed on [lris application md that I assume II responsibility for
compliance with the VJheat Ridge Building Code (U.B.C d a(1 other appticabte
Wheat Ridge Ordinances, for work under this 't.
(OWNER)(CONIRACTOR ~ ~1 '
Construction Value: 1, ~ °j3, cSD
Permit Fee:
Plan Review Fee:
Use TaY:
TOC21:
SIGNED DATEL/-,-- / .
Description: ~
c2 ~ye'.2✓ oF G T s;
BUILDING DEPARTMENT USE ONLY
SIC: Sq.Ft.:
ZONING COMMENTS:
ApprovaL
Zoning:
BUILOING COMMENTS:
Approval:
PUBLIC WORKS COMMENTS: '
Approval:
Occupancy: Walls: Roof: Stories: Residential Units:
Electrical License No: Plumbing License No: Mechanical License No:
CompanY ComPanY: Company:
Expiration Date: Expiration Date: Expirarion Date:
Approval: ApprovaL Approval:
(I) Ilus pesmit waz issued in accordance with the provisions set forth in yow applicatiou md is subject to the laws of the State of Colo:ado md to Ne Zouing
Regulations and Building Codes of Wheat Ridgq Colorada or auy other aopGca6le ord'wances ofthe CiTy.
(Z) "WS "rTmit s7;aU ='ri n i: (A) the work autliorizcd is aot comme¢ced withia siz.y (60) days 5om isxuz dace or (3) the building anthorimd is suspendzd cr
a6andoued for a period of 120 days. (3) Sf tltis perm$ expires, a new permi[ may he acquired for a fee of one-half tlm amowt nolmally required, pmvided no changes have beeo or will be mad< in
Ne ongi¢al plavs md specificarions mmd any snspension or abandoume¢thas mt exceeded oue (1) year. IIchanges have been or ifsuupension or abandovment
exceeds one (1) yeaz, full fees xhall be paid for a new peanic (a) No work of any mannex shall be done chat will change the uarural flow of water causing a drainage problem.
(5) ContractorshallnoRfyCheBuildinglas?ectorRVCnty-fow(24)howsinadvancefocallinsoec¢onsa¢dshallaceivewdtte¢app[ovaloninspecfio¢cazdbefore
praceedingwilhsuccessivephuesofNejob. (6) ?Iie issvance of a pennit or the approval of drawings md specifications suall not be consWed to be a pvmit for, ¢or au appmval a$ my violatio¢ of the
orovisions of L4e bNLding codes or any other ordinance, law, rule orregulaeo¢.
ChisT Building Insnector