The URL can be used to link to this page

Home My WebLink About3890 Marshall StreetcP617G INSPECTION RECORD INSPECTION ONLINE FORM: http://www.ci.wheatridge.co.us/inspection INSPECTION REQUEST LINE: (303) 234-5933 Cancellations must be submitted via the online form before 8 a.m. the day of the inspection Occupancy/Type s S � � 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 Spaces pertinent to this project Foundation Inspections Date Inspector Comments Initials Pier Concrete Encased Ground (CEG) Foundation / P.E. Letter Do Not Pour Concrete Prior To Approval Of The Above Inspections Underground/Slab Inspections Date Inspector Initials Comments Electrical Wall Sheathing Sewer Service Mid -Roof Plumbing Tp.Z C G Do Not Cover Underground or Below/In-Slab Work Prior To Approval Of The Above Inspections Rough Inspections Date Inspector Initials Comments Wall Sheathing Mid -Roof 10 / Ia. Tp.Z C G 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 p — ' 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. "For low voltage permits — Please be sure that rough inspections are completed from the Fire District and electrical low voltage by the Building Division. Occupancy Is Not Permitted Ur C caf - of Occupancy Is Issued Prote,. r- The Weather The City of Wheat Ridge nn Third Party Form Check List Property Address �7� ,� ,,Y: 411 sq Permit Number � 5 Permit Issued Date�� Owner Information Property Owner Information Property Owner Address Inspection Company �f Inspector Name Inspector Contact info. Inspector Statement and Acknowledgement * I hearby acknowledge the roof I am inspecting is 6/12 or over all roofs that are under 6/12 must be inspected by the City of Wheat Ridge Buiding Dept. * 1 hearby acknowledge the roofing system for the referenced building has been inspected and found to be in compliance with the minimum requirements of the 2012 IRC and 2012 IBC as well as all City of Wheat Ridge Policies and Procedure and Manufacturer' recommendation an ti Ls Inspector: Date: ProWrty Owner Statement of Acknowledgement *1 hearby acknowledge that I am the owner of the building referenced above and I ive my consent for the listed third -party inspection company to perform my roof_insp tion in lieu of the City of Wheat Rid Biaildin ivision inspection. Propery Owner/ Agent: Date: This original document as well as the roofing check list, must be submitted to the Chief Building Offical within seven days of the final inspection. Drop off in person Submit via Email Permit counter 2nd floor Kcookni.wheatridlqLco.us 7500 W. 29th Ave Wheat Ridge CO 80033 Drafted Date: 7/26/17 Please add note to reverse side The City of Wheat Ridge inspection Check List notes Mid -Roof _Roof InsQ_e tion Ct N/A D Pass 0 Fail a N/A XPass 0 Fail Structural roof components o Verify that no more than 2 layers of shingles exist R N/A Pass Fail la Flashing for roof and walls 0 N/A Pass Fail If new sheathing is installed verify that it is listed in the p Pass 0 Fail permit description (Valuation must be adjusted) N/A G Pass 0 Fail Verify sheathing nail pattern ( See policy & Proceedures) Crickets and saddles where needed AN/A o Pass o Fail 0 Verify B vent must have boot same gauge as pipe 0 N/A A Pass Fail ❑ N/A j�` Pass o Fail Verify vent caps /XPass 0 Fail Verify no flashings are damaged or rusted Ci N/A o Fail Step flashing shall be min. of 4x4 piece per shingle a N/A 0 N/A Pass 0 Fail Verify scuppers allow for proper drainage 0 N/A Pass 0 Fail Ice and water shield 2' in heated wall spaces 0 Fall Underlayments must follow 2012 IRC / 2012 IBC p N/A t Pass c Verify roof slope for proper drainage 0 N/A K Pass Fail a Fail Dripedge shall have min of 2" overlap Ci N/A Pass 0 Fail Dripedge should extend down min 2" past roof deck 0 N/A Pass Fail Dripedge shall be mechanicaly fastened 12" OC o N/A Pass 90 LB roll roofing shall not be applied to roof slopes XNIA Cl Pass 0 Fall less than 2:12 slope: Exception, detached garages, patios, carports, open on three sides with min, slope of 1:12 Modified Bitumen, EPDM, TPO min slope 1/4:12 slope N/A 0 Pass 0 Fail Above roof insulation R-25 N/� 13 Pass 0 Fail 0 Fail Below roof residential R-38 /A 0 Pass Ait/N/)O,N/A Below roof commercial R-32 0 Pass 0 Fail Modified Bitumen, EPDM, TPO min slope 1/4:12 slope yn N/A 0 Pass 0 Fail f` be installed in accordance with the manufacturers must specifications- Must have manufactures letter of warranty with the address on the letter for final inspection Metal Roof Shingles Requirements 0 Fail Metal roof shingles shall not be installed on slope less /A 0 Pass 3:12 Metal valley flashing shall be the same material as roof N/A c3 Pass 0 Fall Metal valley flashing shall extend a min of 8" from the S N/A Cl Pass o Fail - centerline with a min. of 3/4 " high splash diverter rib built-in at the flow line with sections overlapping a a min. of 4" Tile Roofs Reguirements c Fail Clay and concrete tile shall have a min. 2-1/2:12 slope A N/A u Pass Slopes 4:12 and under require double underlayment The City of Wheat Ridge Inspection Check List notes Mid -Roof Notes Company Name: Inspector signature:✓ Date of Inspection: �' The City of Wheat Ridge inspection Check List notes Final Roof &J tDA22c_. d/A a Pass Pas mon, o Fail o Fail Structural roof components VA Cl Fail Verify that no more than 2 layers of shingles exist VA Pass Pass a Fail Flashing for roof and wails SIA ❑ Fall if new sheathing is installed Verify that it is listed ill the C7 Pass permit description (Valuation must be adjusted) 41A 0 pan D Fail Verify sheahing nail pattern ( See policy & Proc eedures) ;PL v Pais o Fa Crickets and saddles where needed Pass es Fall Verify B vent must have boot same gauge as pipe NIA SIA Pass U Fall Verify vent comps N/A ass o Fail Verify no flashings are damaged or rusted Pass £t Fail Step fleshing shall be min. of 4X4 piece per shingle N/A WA xpaz a Fall Verify scuppers allow for proper drainage N/A .=Pass U Fall Ice and water shield 2' in heated wall spaces N/A Pass Q Fail Underlayments must follow 20112 IRC / 2012 IBC 'X N/A �pess to Fail Verity roof slope, for proper drainage Pass 0 Fail Dripedge shall have min of 2" overlap WA WA paw u Fall Dripedge should extend downs ruin 2" past roof deck n Fail Dripedge shall be mechanicaiy fastened 12" OC N/A PM 90 LB roll roofing shall not be applied to roof Slope$ N/A o Pass 17 Fall less than 2:12 slope: Exception, detached garages, patios, carporta, open on three sides wlm min. slope of 1-12 �/A o Pass a Fail Modified Bitumen, EPDM, TPC? min slope 1/4:12 slope NIA a Pass a Fail Above roof insulation R-25 'WA a Pass a Fall Below roof residential R-38 a pas O Fall Below roof commercial R-32 N/A 0 Fall Modified Bitumen, EPDM, TPO rein slope 114:12 slope INuA a Paw must be installed In accordance with the manufacturers specifications- Must have manufactures letter of warranty with the address on the letter for final inspection N+ .gQQf fi ingles.Reautrern2 Metal roof shingles shall not be installed on slope less �N/A a Pass Cf Fail 3:12 , 'day*y "t�'86s'i yng shW& bathe same maA'taftt alis roof L WA a PM 1 a Fait Metal valley flashing shall extend a min of 8" from the nitA o p� a Fail centertlne with a min. of 314 " high splash diverter rib built-in at the tiow line with sections overlapping a 1 a min. of 41 Til® Roafa ('� Clay and concrete the shall have a rain. 2-1/2.12 slope (N/A a Pass a Fail Slopes 4:12 and under require double undertayrnent The City of Wheat Ridge inspection Check List notes Final Roof Company Name:��/e1e�/ Inspector signature: ®ate of Inspection: City of Wheat Ridge Residential Roofing PERMIT - 201704857 PERMIT NO: 201704857 ISSUED: 07/26/2017 JOB ADDRESS: 3890 Marshall ST EXPIRES: 07/26/2018 JOB DESCRIPTION: Residential Re -roof to install GAF Timberline Architectural Lifetime asphalt shingles with 26 sq. *** CONTACTS *** OWNER (303)929-9779 TUCKER STEVEN J SUB (303)501-0020 Kelly Stitzer 170401 CIG Construction *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 15,000.00 FEES Total Valuation 0.00 Use Tax 315.00 PAID Permit Fee 283.55 ** TOTAL ** 598.55 *** 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) is required on the entire roof when spaced or board sheathing with ANY gap exceeding one half inch exists. Sheathing and mid -roofs may be called in at the same time, one hundred percent of the sheathing must be complete and 25-75 percent of the mid -roof may be complete. 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 - 201704857 PERMIT NO: 201704857 ISSUED: 07/26/2017 JOB ADDRESS: 3890 Marshall ST EXPIRES: 07/26/2018 JOB DESCRIPTION: Residential Re -roof to install GAF Timberline Architectural Lifetime asphalt shingles with 26 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 le ally authorized to include all entities named within this document as parties to the work to be perform t all work to be performed is disclosed in this document and/71�-/r-? ''acco panying approved plans and specifications. % Signature of OWNER or CONTRACTOR (Circle one) Date t r 1. This permit was issued based on the information provided in thepermit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, po icies 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 Budding Official and may be subject to a fee equal to one-half of the originalpermit fee. 3. If this permit expires, anew 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 changeof 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 any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of iSWEfiI3hi121ing -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: Tuesday, July 18, 2017 9:47 AM To: CommDev Permits Subject: Online Form Submittal: Residential Roofing Permit Application Categories: Danny 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 3890 Marshall St. Wheat Ridge, CO 80033 Property Owner Name Steven Tucker Property Owner Phone (303) 929-9779 Number Property Owner Email Field not completed. Address `Vb s`L �• s � 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 CIG Construction Contractor's License In�rece�� t�6a 1 Number (for the City of Wheat Ridge) Contractor Phone 303-501-0020 Number Contractor Email Address info@cigconstruction.com Retype Contractor Email info@cigconstruction.com Address DESCRIPTION OF WORK Are you re -decking the (:E)_ roof? Description of Roofing GAF Timberline lifetime architectural shingle Material Select Type of Material: Asphalt If "Other" is selected Field not completed. above, describe here: How many squares of the 26 material selected above? Does any portion of the property include a flat roof? If yes, how many squares on the flat roof? No Field not completed. TOTAL SQUARES of all 26 roofing material for this project Provide additional detail Complete reroof, tear down to decking, pitch 4:12 here on the description of z work. (Is this for a house or garage? What is the roof pitch? Etc) Project Value (contract 15000 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 Kelly Stitzer Email not displaying correctly? View it in your browser. 3 DocuSign Envelope IDS 524EF736-76E8-4FEA-9F9E-5F1A78COD10C CIG Construction 1501 W. 124t1 Ave. #600 Westminster, CO 80234 720.897.1886 info@CI Gconstruciion.com coi, li TEi',.Ivi Sr CLIENT NAME: Steven Tucker PHONE: 303-929-9779 ADDRESS: ars astreet EMAIL: fiber-tech@centurylink.net CITY: wheat midge INSURANCE: Farmers STATE: CO ZIP: 3 CLAIM #: 3008586161-1-1 Scope of Work III Materials To Be Provided. The Contractor agrees to supply the following materials and perform the work as follows: (The Work) ® Remove 1 I!ers of shinq� ❑ Install Ridge Vent WARRANTY AF T�mbe 1ne HD ❑x Shingle Brand Weathered Wood ® Install Drip Edge A ❑ Standard Warranty - covers ®Shingle Color ®Turtle Vent �f 2 years workmanship. ® Replace Decking ❑D Pipe Jack ® Install _ Ib felt paper @ Synthetic felt ® Exhaust Cap EXTENDED WARRANTIES ® Install Ridge z ridge ® Heater Cap ® Install Ice & Water ElReplace / Repair Gutter El GAF System Plus ❑ GAF Silver Pledge ® Valleys 2 Lines ❑ Replace / Repair Downspouts GAF Golden Pledge ® Eaves Gutter / Downspout Color ❑ Shed Roof ❑ OC Preferred Protection ❑ Garage Roof Scope of Work / Special Instructions: Replace entire roof. Approximate Date of Service: 111012011 Good Faith Estimate This is a good faith estimate $ 12 ' 998.84 (the final purchase price will be the total that is agreed to by CIG and Owner's insurance carrier.) Estimate project price, which is the sum of the agreed cost of repairs related to the claim, for the performance of the Work (the Purchase Price'). The Purchase Price shall be paid as follows 5,626.50 A. $Tau - Unless otherwise staled, deposit to be the ACV amount provided by insurance and due upon start of installation. DG B. $ —Deductible due upon start of installation. C. $—Payment in full due upon receipt of insurance proceeds or within 30 days of substantial completion. Unless otherwise stated, payment shall be due as work is completed and shall be due in full on substantial completion. If the property owner plans to pay for the roofing services through an insurance claim, the contractor cannot pay, waive or rebate the homeowner's insurance deductible in part or in whole. 3. Contingent Upon If initialed by the Owner, then the contract is contingent upon insurance approval. When the insurance carrier agrees to pay the claim for damage to the property, then the Owner agrees to allow CIG Construction to perform all repairs prescribed by CIG Construction and agreed to by Owner's insurance carrier. By reference, CIG Construction's est mate becomes, and here is, part of this contract. 4. Right of Rescission Owner has 72 hours after this Agreement is executed to cancel or rescinded without penalty. This right of rescission is allowed under C R.S. 6-22-104, as amended. A penalty equal to 20% of estimated cost of repairs will apply after the 72 hour rescission period. 5. CIG AGREES TO HOLD IN TRUST ANY PAYMENTS RECEIVED FROM OWNER UNTIL CIG HAS DELIVERED MATERIALS TO OWNER'S RESIDENCE OR UNTIL CIG HAS PERFORMED A MAJORITY OF THE SERVICES UNDER THIS AGREEMENT ON OWNER'S PROPERTY. THIS OBLIGATION APPLIES ONLY TO ROOFING SERVICES AND MATERIALS FOR RESIDENTIAL PROPERTY AS DEFINED UNDER C.R.S. 6-22-102(2)(A)(1) AND (1), AS AM NPNJ?,, _._ ._.._ 7/19/2017 Owner_ . r Date onii won, LLC Owner Date M� 6/21/2017 onsVrucfion, LLC Representative Date `��` MasteElite ROOFS PREFERRED OBS aat,n$:A- POOFIN. CONT.AC1'OR5 FOR TROOPS CONTRACTOR 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: �� C- 9- �:" Job Address: 3� 9 0 iy') �t,�s ��, �l S 4 - Permit Number: "a- O r `7 0 W g s t` r ,-1- L LlNo one available for inspection: Time `� = 1 A ')PM Re -Inspection required: es, No When corrections) have been made, call for re -inspection at 303-234-5933 Date: 2 /'a t I 1-7 Inspector: `- 6 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: NN1 A L) Job Address: 9 o r:'1 ,P as Permit Number: / 1 0 14 IV k- ❑ No one available for inspection: Time U U M/PM Re -Inspection required: Yes 'No CA When corrections have been ma , call for re -inspection at 303-2734-5933 Date: / ' / Inspector: ,.f Vi DO NOT REMOVE THIS NOTICE Date: Permit Building Permit Application Property Address: Property Owner (please print): Phone: City, State, Zip: Contractor License #: -�) � 2= Phone: Sub Contractors* Electrical City License #: Plumbing City License #: Mechanical City License #: Company Company Company. Sq. Ft,/L.Ft added: Squares BTU's _ Gallons _ Amps _ OWNERICONTRACTOR SIGNATURE ♦ UNDERSTANDING AND AGREEMENT WN0". i N • N; W-01*1 Alum it 1:911411 WFIN" BUILDING DEPARTMENT COMMENTS: OCCUPANCY: RevieWit: r-11111,1 ♦~~4' CITY OF WHEAT RIDGE / Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office ' (303) 235-2857 Fax INSPECTION NOTICE Inspection Type: fE fi Job Address/Permit Number: 39'9€a 1;;F ssrW1 5 r. Z,5., ❑ No one available for inspection: Time AM/PM Re-Inspection required: 'Yes<2110D When corrections have been made, call ~for~re-inspection 'at 303-234-5933 Date: Inspector. DO NOT REMOVE THIS NOTICE 41 CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office - (303) 235-2857 Fax INSPECTION NOTICE Inspection Type: P.vs 1_ ! €d7A Job Address/Permit Number: SoMP "~gS,ldllf s77, ef) Y_,r_` ? jeA1; VF /P- 0°,3"W1 i 0 a 4--oUI T acct ~5 ❑ No one available for inspection: Time e? AM/PM Re-Inspection required: "YesJ No When corrections have been made, call for re-inspection at 303-234-5933 Date: 61,;I *z Inspector: 2 e_ p DO NOT REMOVE THIS NOTICE E i ♦~,41 CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office ' (303) 235-2857 Fax INSPECTION NOTICE .f Inspection Type L' Job Address/Permit Number: 3 a-` ~f i~c 73 ,L~ ~ ❑ 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: C- Inspector PZ % DO NOT REMOVE THIS NOTICE UVI ,75 220. WHEAT ~oF City of Wheat Ridge Building Division m 7500 W. 29th Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-235-2857 c o Inspection Line: 303-234-5933 OCORPD Date: (76/ f t ] r9CG, Pian Permit Building Permit Application Property Address S' 0 ( Property Owner (please print): gewo j J Gf-yr Phone: Mailing Address: (if different than property address) Address: `31910 moc4NcA 4 City, State, Zip: Contractor:. Contractor License Sub Contractors: Electrical City License Company: I Lo Phone: Plumbing City License Company Lc Mechanical City License Company: Exp. Date: Exp. Date: Exp. Date: Approval: Approval: Approval: Use of space (description): Construction Value: $ o?Ot7 Description of work: (as calculated per the Building a/uat/on Data sheet) 7 tT~-A v- r~~rIn Plan Review (due at time of submittal): $ f Sq. Ft./L.Ft added: o~ 1 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. Plans subject to field inspection. CIRLCE ONE:: OWNER) (CONTRACTOR) o , P RSONAL REPRESENTATrItV f (OWNE/R) (CfO~NTRATOR) PRINT NAME: c- j zr. SIGNATURE: C ZtrD~ V~\~ • Y - Date: