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Home My WebLink About4711 Marshall StreetINSPECTION RECORD IF CTION ONLINE FORM: http://www.ci.wheatridge.co.us/forms.aspx?fid=79 INSPECTION REQUEST LINE: (303) 234-5933 Occupancy/Type Inspections will not be performed unless this card is posted on the project site. C _.)ection request line before 11:59 p.m. to receive an inspection the following business day.** Inspector Must Sign ALL Spaces pertinent to this project Foundation Inspections Date Inspector Comments Initials Pier Concrete Encased Ground (CEG) Foundation / P.E. Letter Liu IVut i -our I.OnCfPTR iYrinr in Annrnuni i it 1 ha Ahnvn Incr�nr+i.�r�� Underground/Slab Inspections Date Inspector Initials Comments Electrical Sheathing d Sewer Service Plumbing LAV IVVI %.VVCI ulla@rarouna Or 6PIOVWIn-51An vvnrlc wrinr irk Onnrmini rlt -uhn Ahnvn Rough Inspections Date Inspector Comments Initia Sheathing d Mid -Roof? Lath / Wall Tie Rough Electric Rough Plumbing/Gas Line Rough Mechanical Rough Framing Rough Grading Insulation Drywall Screw/ Nail Final Inspections Date Inspector Initials Comments Landscaping & Parking / Planning Dept. Inspections from these entities should be requested one week in advance. For landscaping and parking inspections call 303-235-2846. For ROW and drainage inspections call 303-235-2861. For fire inspections contact the Fire Protection District for your project. ROW & Drainage / Public Works Dept. Floodplain Inspection (if applicable) Fire Inspection / Fire Protection Dist. Final Electrical Final Plumbing Final Mechanical Roof 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. a'S M -'....aa - ivaao uu Oulu uiaL 1uuyn uibpccunc us are urnpieteu Trum ine rlre uisinct ana electrical low voltage by the Building Division. Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued Protect This Card From The Weather City of Wheat Ridge Residential Roofing PERMIT - 201702214 PERMIT NO: 201702214 ISSUED: 06/20/2017 JOB ADDRESS: 4711 Marshall ST EXPIRES: 06/20/2018 JOB DESCRIPTION: Re -roof using asphalt shingles 15 SQ *** CONTACTS *** OWNER (352)214-7639 JEREMY RICHARD GC (720)242-6404 Rex Corly 150303 Masterpiece Roofing & Painting *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 3,750.00 FEES Total Valuation 0.00 Use Tax 78.75 Permit Fee 109.20 ** TOTAL ** 187.95 *** 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 A/2 -inch exists. Asphalt shingles are required to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield is required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave and secured in place is required to be provided for all roof inspections. Roof ventilation is required to comply with applicable codes and/or manufacturera€'"s installation instructions, whichever is more stringent. In order to pass a final inspection of elastomeric or similar type roof coverings, a letter of inspection and approval from the manufacturer's technical representative stating that "the application of the roof at (project address) has been applied in accordance with the installation instruction for (roof material brand name) roof covering" is required to be on site at the time of final inspection. PERMIT NO: JOB ADDRESS: JOB DESCRIPTION: City of Wheat Ridge Residential Roofing PERMIT - 201702214 201702214 ISSUED: 06/20/2017 4711 Marshall ST EXPIRES: 06/20/2018 Re -roof using asphalt shingles 15 SQ *** CONTACTS *** OWNER (352)214-7639 JEREMY RICHARD GC (720)242-6404 Rex Corly 150303 Masterpiece Roofing & Painting *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION:»gam N FEES ---- Total Valuation 0.00 Use Tax 78.75 Permit Fee 109.20 ** TOTAL ** 187.95 *** 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 A/2 -inch exists. Asphalt shingles are required to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield is required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave and secured in place is required to be provided for all roof inspections. Roof ventilation is required to comply with applicable codes and/or manufacturera€ms installation instructions, whichever is more stringent. In order to pass a final inspection of elastomeric or similar type roof coverings, a letter of inspection and approval from the manufacturer's technical representative stating that "the application of the roof at (project address) has been applied in accordance with the installation instruction for (roof material brand name) roof covering" is required to be on site at the time of final inspection. City of Wheat Ridge Residential Roofing PERMIT - 201702214 PERMIT NO: 201702214 ISSUED: 06/20/2017 JOB ADDRESS: 4711 Marshall ST EXPIRES: 06/20/2018 JOB DESCRIPTION: Re -roof using asphalt shingles 15 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 applicab municipal codes, policies and procedures, and that I am t e legal owner or have been authorized by the legal owner of the propertx nd a uthzed to obtain this permit and perform the work described and approved in conjunction with this ermrt. I further attest that ' le 1 ' horized to include all entities named within this document as parties to the work to be performed and that all wor o per r� is�iss�ose ia� t�ris�document and/or its' accompanying approved plans and specifications. Signature of OWNER `or CONTRACTOR (Circle one) '-- Date I. This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and maybe subject to a fee equal to one-half of the original permrt 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 an manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or 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 e or any 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. Inspection time requests will be accepted by email only. Please email requests to insptimerequest@ci.wheatridge.co.us between 7:30am and 8:00am, the morning of the inspection. Please put the address of the inspection in the subject line. Antoinette Kulick a; 1J)q a ZIaj y From: no -reply@ ci.wheatridge.co.us Sent: Monday, June 12, 2017 11:12 AM To: Permits CommDev Subject: Online Form Submittal: Residential Roofing Permit Application Residential Roofing Permit Application This application is exclusively for new permits for residential roofs and for licensed contractors only. This type of permit is ONLY being processed online --do not come to City Hall to submit an application in person. Permits are processed and issued in the order they are received. YOU WILL BE CONTACTED WHEN YOUR PERMIT IS READY FOR PICK-UP AND WILL BE GIVEN A SPECIFIC DATE AND TIME WINDOW TO COMPLETE THE TRANSACTION. You will be notified if your contractor's license or insurance has expired, and you may update those documents at the time you are issued your permit. Permits are currently being processed within 3-5 business days, subject to change based on volume. For all other requests: Homeowners wishing to obtain a roofing permit must apply for the permit in person at City Hall. Revisions to existing permits (for example, to add redecking) must be completed in person at City Hall. All other non -roofing permits must be completed in 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. PROPERTY INFORMATION Property Address Property Owner Name Property Owner Phone Number Property Owner Email Address Do you have a signed contract to reroof this property? It will need to be provided at the time of permit pick-up. 4711 Marshall st. Jeremy Richard 352-214-7639 Field not completed. Yes CONTRACTOR INFORMATION Contractor Name Masterpiece Roofing Contractor's License 150303 Number (for the City of Wheat Ridge) Contractor Phone 7202426404 Number Contractor Email Address scott@masterpieceroofing.com (permit pick-up instructions will be sent to this email) Retype Contractor Email scott@masterpieceroofing.com Address DESCRIPTION OF WORK Is this application for a Yes new permit for a residential roof? Are you re -decking the No roof? Description of Roofing Certainteed Landmark Material Select Type of Material: Asphalt If "Other" is selected Field not completed. above, describe here: How many squares of the 15 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 15 roofing material for this project z Provide additional detail here on the description of work. (Is this for a house or garage? What is the roof pitch? Etc) Project Value (contract value or cost of ALL materials and labor) single family dwelling, house, 5/12 pitch 1 layer 3750 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 scott campbell Email not displaying correctly? View it in your browser. 3 Roofing - Siding :: Windows :: Painting/Coating Property Owner ("Owner") . t Email Je nu k r% cl-)C S'CAax) Street ("The Property") City St��zip_�Wj Home Phone Cell -3 2 2-I Lf 7 %,3 ell Insurance Company A 1 e. Claim # �n y�S S Adjuster Phone Shingle Manufacturer Estimated Xactimate Price ce Year olor Down Payment t� Tear off 1 layer(s) of asphalt/shake/tile shingles Balance c-, l Install Sheath ing_7/16"OSB_1/2"CDX plywood First insurance check, deductible & upgrades are due prior to scheduling the job. Where X Install felt_15lb_301b others., �c X Ice & Water shield to code e �C Install Metal Drip Edge. Color U , _ 6 nail pattern on shingle (+20mph wind resist) ?<Valley(s) will be x closed _open install new pipe jacks ZC Install new vents as needed _ Install In. ft. of vent -a -ridge Re -flash chimney brick/wood size Re -flash wall abutment as needed if possible (Stucco or siding may be a deterrent) To clean up & haul away all job related debris k Magnetic sweep of the yard for removal of nails X5 year workmanship warranty Special instructi Improvements in exchange for Insurance Scope, Breakdown and Supplemental Proceeds Owner authorizes Elite Exteriors ("Contractor') to contact the Owner's insurance company regarding damage to the Property. Owner understands that the Contractor will assist the Owner in obtaining appropriate property insurance damage adjustments, gaining approval of damage for repair and obtaining funds to repair Owner's Property. Owner authorizes Owner's insurance company to discuss all matters directly with Con- tractor, or their representative. Owner agrees to provide Contractor with any and all Insurance information, claim number, insurance loss data information and adjuster's report provided to the Owner by the Insurance Company. Upon authorization of the Owner's Insurance Company, for a price agreeable to the Contractor, Owner agrees that the Contractor shall perform work prescribed by the Insurance Company's loss data sheet or adjuster's report which includes the estimate of repair as set forth in the insurer's claim file plus any upgrades selected by the Owner. Owner is obligated to pay only the deductible required by the Owner's Insurance Company plus any upgrades requested by the Owner. owner further agrees to endorse insurance checks payable to the Contractor or to pay the Contractor an equal amount upon completion of the work. Owner owes the Contractor nothing in the event the Insurance Company does not authorize the repairs. Otherwise, Owner understands that this is a binding agreement. If the Owner breaches this agreement before commencement of the work, Owner agrees to pay the Contractor twenty five percent (25'0) of the total sum of the work authorized by the Owner's Insurance Company. Owner understands that, aside from upgrades, a summary of the work to be performed, a description of materials to be used or a list of standard features included, the total contract price, or description of the basis on which the price will be calculated, is embodied in the insurance loss data information provided by the Owner's insurer. Further, Owner authorizes the Contractor to submit supplemental requests to the Insurance Company for additional payment required for omitted items from adjuster scope or due to price fluctuation caused by supply/demand issues. Owner warrants that this contract is signed without any reliance upon any specifically written in this contract; and that no additional promises or r i reading all the Terms and Conditions on the reverse side of this document. Date— 15__r(—) N -L-7 Contra . Humboldt St. Denver, CO 80205 ons or promises by the Contractor, or its agents, except those that are have been offered as i u ment for signing. Owner also acknowledges Property Owner d vc ft� Property Owne Office: 720-810-1785 eliteexteriorsdenver.com TERMS AND CONDITIONS 1. All contracts are subject to approval of Management and our Credit Department without exception. 2. All checks for payment must be made payable to Elite Exteriors. There will be NO exceptions. Owner will still be liable to Elite Exteriors for payment of this contract if check is made out to any other entity or person. 3. If any provision of this agreement should be held to be invalid or unenforceable, the validity and enforceability of the remaining provisions of this agreement shall not be affected thereby. 4. Owner further agrees that the equity in this Property is security for this contract. 5. Payment in full shall not be held up while waiting for the city, county or appropriate building inspection department to inspect the work. Owner understands that the city, county or appropriate building inspection department is not within the control of the Contractor. 6. Contractor shall not be liable for failure of performances due to labor controversies, strikes, fire, weather, inability to obtain material from usual sources or any other circumstances beyond the control of the Contractor, whether of a similar or dissimilar nature. 7. Should a default be made in payment of this contract, charges shall be added from the date thereof at a rate of one and one half percent per month (18% per annum) with a minimum charge of $2.00 a month and if placed in the hands of an attorney for collection, all attorney's fees and legal filing fees shall be paid by the Owner accepting said contract. 8. This contract cannot be cancelled once insurance negotiations begin or work has commenced except by mutual written agreement of both parties_ 9. If this contract is cancelled by the Owner later than three (3) days from execution, the Owner shall pay Elite Exteriors twenty five percent (25%) of the contract price as liquidated damages, not as a penalty and Elite Exteriors agrees to accept such as just compensation for cancellation. 10. In addition to paragraph 9, if material has been reordered or restocked because of a cancellation by the Owner, there will be a restocking fee equal to fifteen percent (15%) of the contract price. 11. Replacement of deteriorated sheathing, pipe jacks, ventilators, flashing or other materials unless otherwise stated in this contract are not included and will be charged as an extra on a time and material basis. 12. The Contractor's Limited Warranty does not cover damage to roofs caused by lightning, gale (50mph), hurricane, tornado, hailstorm, impact of foreign object, other violent storm casualty or damage to roofs due to settlement, distortion, failure or cracking of the roof sheathing, walls or foundation of the building. 13. The Contractor is not responsible for any damage below the roof due to leaks by excessive wind, ice or hail during the period of the warranty. The Contractor's warranty covers the roof only. 14. The Contractor will not be held liable for any structural movement, settling, cracks in dry -wall, cracking or breaking of driveway during the roofing or loading process and minor scratching or denting of gutters. 15. All pictures, wall hangings, lights, collectables, etc. both indoors and out MUST be secured by the Owner. Any damage to personal items during installation will not be the responsibility of the Contractor. The Contractor will not be responsible for nail damage to tires, pets, etc. Pets should not be left unattended during installation. 16. Any alteration or deviation from specifications involving extra cost will be executed only upon written orders and will become an extra charge over and above the estimate. 17. The Owner is to carry fire, tornado and other necessary insurance. 18. This contract and labor warranty shall not be assigned and are non -transferable unless specified in writing. 19. The Contractor shall revoke the labor warranty if this contract is not paid in full. 20. This contract constitutes the entire understanding of the parties and no other understanding, collateral or otherwise, shall be binding unless in writing and signed by both parties. 21. This agreement is composed of a front and back page and all materials incorporated herein by reference and shall be considered the entire agreement by the parties. Any representation, statements or other communications not written in this contract are agreed to be immaterial and not relied on by either party and do not survive the execution of this contract. 22. The Contractor has the right to order excess materials. All excess materials belong to the Contractor. 23. The Contractor reserves the right to file for supplemental insurance claims if the insurance adjuster's measurements are used and prove to be incorrect. 24. At no additional cost to the Owner, the Contractor reserves the right to file for a supplemental insurance claim due to an increase in costs. 25. Supplements paid by the Insurance Company for additional labor or materials needed beyond the original scope of repairs are part of this contract as if contained herein and will be paid to Elite Exteriors either by the Owner or the Owner's Insurance Company. 26. Owner acknowledges Elite Exteriors as a General Contractor and as such will be,entitled to 10% overhead and 10% profit if approved by the Insurance Company as part of the claim. 27. Owner is responsible for the Homeowners Association's (Covenant) approval of roofing products and color. 28. Elite Exteriors is not responsible for damage to stucco, siding or wall abutments as a result of installing new flashing. 29. Elite Exteriors is not responsible for satellite dish realignment. A City of Wheat Ridge Residential Roofing PERMIT - 201702214 PERMIT NO: 201702214 ISSUED: 06/20/2017 JOB ADDRESS: 4711 Marshall ST EXPIRES: 06/20/2018 JOB DESCRIPTION: Re -roof using asphalt shingles 15 SQ **REVISION**Adding redecking; Adding valuation: $2,250.00 *** CONTACTS *** OWNER (352)214-7639 JEREMY RICHARD GC (720)242-6404 Rex Corly 150303 Masterpiece Roofing & Painting *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA ! Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 , *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 6,000.00 FEES Total Valuation 0.00 Use Tax 126.00 Permit Fee 140.90 - ---- ** TOTAL ** 266.90 *** COMMENTS *** *** CONDITIONS *** Effective December 1, 2014, asphalt shingle installations require an approved midroof inspection, conducted when 25-75 ,percent of the roof covering is installed, prior to final approval. Installation of roof sheathing (new or overlay) requires an approved inspection prior to installation of ANY roof coverings and is require on the entire roof when spaced or board sheathing with ANY gap exceeding k/2 -inch exists. Asphalt shingles are required to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield is required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave and secured in place is required to be provided for all roof inspections. Roof ventilation is required to comply with applicable codes and/or manufacturer&4Fms installation instructions, whichever is more stringent. In order to pass a final inspection of elastomeric or similar type roof coverings, a letter of inspection and approval from the manufacturer's technical representative stating that "the application of the roof at (project address) has been applied in accordance with the installation instruction for (roof material brand name) roof covering" is required to be on site at the time of final inspection. City of Wheat Ridge Residential Roofing PERMIT - 201702214 PERMIT NO: 201702214 ISSUED: 06/20/2017 JOB ADDRESS: 4711 Marshall ST EXPIRES: 06/20/2018 JOB DESCRIPTION: Re -roof using asphalt shingles 15 SQ **REVISION**Adding redecking; Adding valuation: $2,250.00 I, byy myy siggnature, 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 ermrt. 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. Signature of OWNER or CONTRACTOR (Circle one) Date I, 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, 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 originalermit 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 any ordinance or regulation of this i risdiction. Approval of work is subject to field inspection. Signature of Chief BuildingWcial Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Inspection time requests will be accepted by email only. Please email requests to insptimerequestgci.wheatridge.co.us between 7:30am and 8:00am, the morning of the inspection. Please put the address of the inspection in the subject line. City of W heatj�id�e COMMUNITY DEVELOPMENT Building & Inspection Services Division 7500 W. 291h Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: permits(aD_ci.wheatridge.co.us FOR OFFICE USE ONLY Date: Add to Permit # 10 )Wa I l Building Permit Revision/Amendment Application *** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: g 711�zy d� --t l 5'r Property Owner (please print): vmW (Z t (rraV'j Phone: Property Owner Emai Mailing Address: (if different than property address) Address: City, State, Zi Submitting Company: Contact Person: Contractor: I-nc'cLlf I Contractors City License #: Contractor E-mail Address: Phone: Phone: r706) Z 6gby 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: d eC;GC Sq. Ft./LF Amps Btu's Gallons Squares Z' S Other Additional Project Value: (Must include all general and subcontracted work to be performed related to revisions/amendments described above) ZZS6 6.,o 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. CIRCLE ONE: (OWNER) (CONTRACTOR) or (AUTHOR ED EPRESENTATIVE) of (OWNER) (CONTRACTOR) PRINT NAME: `5DS(i1 G tOuc tr ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: PUBLIC WORKS COMMENTS: Reviewer: SIGNATURE: �G ` 1/SS�'�L'�9 DATE: r 7 PROOF OF SUBMISSION FORMS Fire Department ❑ Received ❑ Not Required Water District ❑ Received ❑ Not Required Sanitation District ❑ Received ❑ Not Required DEPARTMENT USE ONLY OCCUPANCY CLASSIFICATION: Building Division Valuation: $ i CITY OF WHEAT RIDGE _:�9�Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax Inspection Type: Job Address: Permit Number: INSPECTIO N NOTICE Si 1s I w/ / C/ L L / 1-/ ❑ No one available for inspection: Time `�-��j AM/PM Re -Inspection required: Yes No When corrections have been made, call for re -inspection at 303-234-5933 Date: Inspector: DO NOT REMOVE THIS NOTICE A 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: 1 p Job Address: 4-1/1 S7Permit Number: ) 0 I - -) Ald / A n r Iz �N -- ❑ No one available for inspection: Time AM/PM Re -Inspection require Yes No (�1) , "'� When corrections have been made, call for re -inspection at 03-234-59 3 Date: ')' /0Inspector: DO NOT REMOVE THIS NOTICE I d 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: M Job Address: Lf-� 1 1 S L ST Permit Number: 210 1-) O Z Z / -f ❑ No one available for inspection: Time AMYPM Re -Inspection required: Yes No - When corrections have been made, call for re -inspection at 303-234-5933 Date: ,� c " % Inspector: _ .,r!) , / � ?t6� DO NOT REMOVE THIS NOTICE 4TJ a CITY OF WHEAT RIDGE x _:�9�Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: 'T Job Address: G1'7 (I M c,,S(1c I ( 5 i* Permit Number: 20/76 '2 �9 /V ❑ No one available for inspection: Time r'�'� ' `0 -A--'M/PM Re -Inspection required: Yes (go-, When corrections have been made, call for re -inspection at 303-234-5933 Date: % r Inspector: i DO NOT REMOVE THIS NOTICE INSPECTI RECORD OccupancvlTvpe '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 JOB FOUNDATION INSPECTIONS DATE INSPECTOR INITIALS COMMENTS: Footings /Caissons Stemwall. / Encased Ground - - Reinforcingor.Monolithic nil ry - Weatherproof / French Drain Building Final Sewer Service Lines - Fire Department water Service Lines R.O.W & Drainage POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED CONCRETE SLAB FLOOR Electrical (Underground) Plumbing (Underground) Heating (Underground) DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED .ROUGHS SheathiE Lath / W`Mid -RooElectricaRough E Rough Plumbing Gas Piping Rough Mechanical �. ABOVE INSPECTIONS TO BE SIGNED PRIOR TO PROCEEDING Framing - s Insulation 'Drywall Screw S� FINALS Electrical Plumbing Mechanical' Roof nil ry Building Final Fire Department R.O.W & Drainage INSPECTIONS FOR PLANNING & ZONING, FIRE AND PUBLICE WORKS SHOULD BE CALLED AT . LEAST ONE WEEK PRIOR TO FINAL INSPECTIONS. Parking &.Landscaping ' "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. OCCUPANCY NOT PERMITTED UNTIL CERTIFICATE OF OCCUPANCY IS ISSUED PROTECT THIS CARD FROM THE WEATHER ♦ i CITY OF WHEAT RIDGE Building Inspection Division (303) 2345933 Inspection line (303) 235 -2855 Office • (303) 237 -8929 Fax INSPECT O NOE Inspection Type: t O�dy Job Address: Permit Number: ❑ No one available for inspection: Time A) 4 M PM Re- Inspection required: Yes No "When corrections have been made, Date: : Rv Inspector: ra re- inspection at 303- 2345933 Hk NOTICE ♦ i CITY OF WHEAT RIDGE Bung Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929. Fax IN(S~PECTION NOTICE Inspection Type: Job Address: Permit Number: C CI Z)_ 11:~ 13 No one available for inspection: Time Re-Inspection required:'e No 'When corrections have been made, calf for re-fn: Date: C~Y Inspector: i DO NOT REMOVE THIS ♦ 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: q e\V'6(~ Job Address: 4-71 C ~titO'p 5 ~ Permit Number: ~R a3 ❑ No one available for inspection: Timea./ S A"a Re-Inspection required: Yes V~o "When corrections have been made, call for re-inspection of 303-2345933 Date: C Inspector: t DO NOT REMOVE THIS NOTICE " 41 V, City of Wheat Ridge Residential Roofing PERMIT - 092513 PERMIT NO: 092513 , ISSUED; .09/17/2009 JOB.. ADDRESS: 4711 MARSHALL ST EXPIRES: 03/16/2010 DESCRIPTION: Reroof 27 sqs ***CONTACTS owner Carol Darland 'PARCEL INFO ZONE CODE: UA -USE: UA SUBDIVISION: 0368 BLOCK/LOT#: 0/. FEE SUMMARY ESTIMATED. PROJECT VALUATION: 4,856.00 FEES Permit.. Fee 144.70 Total Valuation .00 Use.. Tax 87.41JJ TOTAL 232.11 T~' Conditions: 6 nail installation mid-roof inspection required. Board sheathing spaced more than a 1/2 of an inch apart requires plywood overlay on entire roof. Ice and water shield required from eave edge to 21 inside exterior walls. Subject to field inspection. / 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 app abl Wheal dge di s, for for der this permit. Plans. subject to field inspection. i < Bi ure ntr o /owner date S; 1. This permit was issued in accordance with the provisions set forth in your application and is subject to the laws of the State of Colorado and to the Zoning Regulations and Building Codes of Wheat Ridge, Colorado or any other :applicable :ordinances of the City. 2 This permit.: shall expire 180 days. from the issue date. Requests. for an extension must be received prior to expiration date. An. extension. may be granted at the discretion of the Building official. gam, 3. If this permit expires, a new permit may. be. acquired for a fee of :one-half the amount normally required, provided no ` rchanges have been or will be made in the original plans and specifications and any suspension or abandonment has not r exceeded one (1) year. If changes have been or if suspension or abandonment exceeds one (1) year, full fees shall be paid for a new permit. - i; 4. No work of any manner shall be done that will change the natural flow of water causing a drainage problem. 5.Contractor .shall notify: the Building Inspector twenty-four (24)' hours in 'advance for all inspections and shall receive 'written approval on inspection card before proceeding with successive phases of the job.. 6. The issuance of a permit or the approval of drawings and specifications shall not be construed to be a permit for, nor an approval . of, any violation of the provisions of the building codes or any other ordinance, law,. rule or regulation. Allplan ev is subject to. field inspections. l Signatu f ief Building Official date INS CTION REQUEST LINE: (303)234-5933 BUILDING OFFICE: (303)235-2855 REQUESTS MUST BEMADE BY 3PM ANY BUSINESS: DAY FOR INSPECTION THE :FOLLOWING BUSINESS DAY. F s. it ( W City of Wheat Ridge Building Division 7500 W. 29th Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Property Address:' Property Owner (please print): Mailing Address: (if different than property address) Address Use of space (description). ItsB c~ G Construction Value: $ 1) Q5Cription of works (as calculated per the Building aluation ata sheet) 3 ` ILH L i Plan Review (due at time of submittal): $ Sq. Ft./L.Ft added: quare BTUs Gallons Amps 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 1 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) or PERSONAL REPRES NTATIVE of (OWNER) (coNT TOR) y ,XJI .~1 y~J PRINT NAME: C:ca✓-n / [ (/,a a . J SIGNATURE: . s X-Date: Bldg Valuation: Date: Plan Permit City, State, Zip: Contractor Contractor License Phone: Sub Contractors. Electrical City License Plumbing City License Mechanical City License Company: Company Company: Exp. Date: Exp. Date: Exp. Date: Building Permit Application COMMUNITY DEVELOPpNfENT EPT. Inspection Services Division (303) 235-2855 Correction Notice Job Address: 4Z71I /yfLQS%~,9GL S~ ~i✓iJL L~L~'TP/~' O/~',D CC'E~T"~i~' /i✓ ~~~9G~ ~ ~i~2f>9-T~-~ ~~r✓ w~,Y ~ When corrections have been made, call for re= spection at 303-234-5933. ~ Inspector DO NOT REMOVE THIS NOTICE ~il/STAIG~» ii✓ Gr/i3ii ~'f~U/?Y 2af ~ COMMUNITY DEVELOPMENT DEPT. Inspection Services Division (303) 235-2855 Correction Notice 7Z7 ~ a~.~~a ~ilC~. When corrections have been made, call for re-inspection at 303-234-5933. / DO NOT REMOVE THIS NOTICE Job Address: Residential Electric anbaii st = mry a rt9obvd &ra ki sfnKilMtie romsl munah n9~k,4 Pmltltl w elutrbhb~rwi~er W MM sqwqmdso oraEutlouat W.mmadador(q7w.IItiYUbnmrderBwyeW~~[~ . eptlekr. mvpaalt . . . . , . etWlMYtluPP lYe.YCnIMOfwalnnaWlo adrWyepnClOB. . ~mPwYUr Iwm1Yhw,(U) ben b~dvm br a Irpeetl^r aW,iJ nwlw wAan oW~MbmpdftdeJ beGn :eneloe. . . . . . . . . , . dnwhp ud AM~ntlwtNE ut be aauuvtlb 6e ~ pnoitfor. uru ~PP~~V $ W~ dYr nYYw.+~IeM~epWbn• . . . ~ ~ . . ' . ~ SRi7tDDAT6 , . . ' e.p f or 1 150 A). Wire new A/C & Fumace COMMUNITY DEVELOPMENT DEPARTMENT Building Permit Number. o~ W"£'l q BUILDING INSPECTION UNE - 303-234-5933 Date: ~ g CITY OF WHEAT R1DGE " 7500 WEST 29TH AVENUE WHEAT RIDGE, CO 80033 - (303-235-2855) APPLICATION rropeny owner: Co~ ( 74.a la Y..d Property Address: cF7! / Phone: Contractor License No.: ~,3 0 Company: 7,) 4r,5 [A «I cJ y~~- rbone: 3- aia -i/yo OWNERiCONTRAC70R 516NANRE OF UNDERSTANDING ANO AGREEMENT ' guildina Dept ValuaUon Figwe: $ 1 hereby certify that the SetDadc disfances proposed Dy this permit applitation are accurate, and do not violate aAWieable adinances, rules or regulations ol the Ciry of Wheat Ridpe or oovenants, easemenls a resUicSOns of record; Mat aA meawrunenb shown, and aNeyations ma0e are acwrate; Ihat I have read arW ayree b abide by aH conditiona printed on thia applieation and that t assume full responsibility for comptiance with the W heat Ridye Buildirp Code (I.B.C) and all olher applicable W heat Ridge OrAinances, for work un"is pennd. I~Jilns subjecl to fieW inspection. (OWNERNGONTMCTOft): ✓t?.v~4l.-D ~I~rOkrrL Value:$ i •!v p ~ Permit Fee:$ Plan Review Fee:$ Use TaX:$ Total:$ Use of Space (description): iZPS. ~7"i ~C Descriptlon of work: 2Q~ <.e, !5R.yt, J S-1) 4) t7~ ~ -I+. eW ~'ie- Sq. Ft. addod BUILDING DEPARTMENT USE OIYLY Approval: Zonirq: COAii.FMS: APP^oval: W owc5 COMMEN75: ApproVal: SIC: Sq.Ft.: IRE DEPARTMEM COMMEN75: AppfoV21: loccupancy: Walls: Roof: Stories: Residential Units: Electrical License No: 3=9;t I "DPlumbing License No: Mechanical license No: Company. ~T f1eK , S,, L Canpany. Company. Expiration Date: ';z1z.Y107 Eupiration Date: Expiration Date: Approval: Approval: Approval: (1) This permit waa issued in accondanoe wiM the povisions xt tath in your applicatbn anE is wbject to the laws oi the State ot Colorxb arM b the Zoninp ReWlations and Buildiny Codea W W heat RiApe. Cobrado w any dher applinbM ordinances ot ttro Cfly. (2) This permit shall eryirs it (A) the work auMorizeE is nd commenoad witAin sixty (90) days (rom issue date w(8) the buil0ing auMaized is waperWed oI sEarbaod for a petiod of 180 Cays. (3) I( 7tis PomiK exWres. a new Dai*nit may be sca+ired tor a fee of one-half the anauM notmally repuiretl. poviOaC ra tlwnges have been orwitl be msES in ths oripinal OWns arW apeciBoUan3 and anY wspenaion a abandonment has rwt enceeded one (1) Ypr. M chanpes have been a if suspenabn ar abandonment axceeda ane (1) Year, lud fees shad be Paid fw a new permil (4) No wOrk o1 anY manrw ahaY be dpfs tltat wiY durpe the naWral Ilow of waler cauefnp a drainape pioblem. (5) Conbscta ahal notily 1M BWldiq Inapecfor 1u'aMY4pr (21) havs in adranoe for aN inspectians and shall reoeive writlen approvd m 4npedim ord befors Proceedi^G vAlh succesaire phases d tlhs job. (6) The isauanoe M a Dffmit a the aPPovy of drarrirps and sVedficatbns shaY nd De conatrue0 b be a Permit ta. rwr an approval ot, a^Y violadon of the proviaiona ot the buildirq oodes a arry oCw «dinance, law, rub a repWaEm. A11 plan rMew b subject lo MW Mspoetbns. Chief Building Official . . ~+s . . L1.i11d111gPV11111L . PermitN18721 . CTl`Y OF VVHEAZRIDGE 5/17/2005 7500 Weat 29TH Avrnue wheatridge, CO 80033 Inspectlon Une . . . ' 303-235-2855 30$-234•5933 ~ ~ . Residential Mechanical PROPFxTY 4711 MarsLall St Unit: oVVrfER: Design Consultants (303) 424-2837 . Ilescrlpdon . . . . . Fumace replacenient, add A/C, EAC, Humid., Themiostat Ciri of Wheat Rldaa PRESCRIETIYE ENERtiY CODE BOILERS I fURNACES A MINIMUM Of 9p9G AFUE • GAS WATER HEA7ERS A MINIMUM OF.Bb ENERGY FACTOR ELECTRtC WATER HEATERS A MINIMUM OF.Y3 ENERGY FACTOR SETBACK THERM06TAT REQUtRED (EXCEPT HYpRONIC HEAI) R•21 YVALLE • R.W CEIUNGS' • R-19 CRAMIN.SPACE6 Unks: Oceupaucy: Walls: Roof: Stode3: Sq Fwt: ro . . r►:,.~w.upn.eme..u.sraraar..vrovosol qwrvorisk wvmwt ..e.ee..w..am.o~.wra+re~~~~•••n•.~a.Wr:~d.a..roruecxY or . : W Wl Wtl{a m e0vecubi ~+NaenY or ruaktlou of reeoNi tle a maiuurtwub ~ho~m~ ud o6PWm o.Ae ue oeMaMi Wt [Ytt rend ud WwW NYely . . tleMdlllop@onhAenLLYsPpYeYloaudNm lawmefa9rt+W.,flAftYforwvVWwwltYlheWhulRi9, 13u11dY[Cade(O.RC.)adJoftv+Wlito64.: . . WhutRW erdls~vn+~faz eY derMi L - . . . ( ,Rj ~ . mnA . . . ' i. Tba Mneft wuiwtlle naordenc<MMiNMWbmMkMbrinpPtleatloamObeNlaccroWeWreo(MSStinafCMM~rdaLLel.riq' nyw.uo.,.mn.uauqcedsorwextnwp,cew.+aoo..nrotha,ppue.nku.ao..ner.ormeciq. . . . . . ] '144pernUµCtleCpbeM(A)NewurkaulbeludbmtaounadwlNNWry(60)Arys&mlwe0~lsor(B)1YeboWl, nilioalsedYOpmdeAw . , . . .bpao.sa k.. pukd on:o a,y. . . . . 3 7(tY4Porwit uWM, a Ctnpern11m16ew9a6tlfar. keMovo-bWHeisoYOtnpfak npMed.V~vided ueYU{nYavebtlsaMbsmMeYW. . . . -OleWtlplw.udipedCftIbneutlaeY~~~w alvd^^mathuaetnamdedeu(1)yer.IfcYuW uteeeMwltwptlon arAudsnwl . . . . eaatd,me(1)YearlfuBksm.&beWidfara aewpamY.. . . . . . . . 4 NowalcNuywea'8dI6eUOn<tWtw9eWp 1heu1on10owofw.hrnuW[aMis~ppables. . . . . S .CNMtbI'.hVYM1UNWLDYIWIS{IYRpGCIir IW!!1Y'WYI(2I)hOYAIONV\\[lMe ~initlfd4YYAlhaYRIXIRntrIMO~Pvamrad OYMorl0nYYf1lAM/m . . . . . pptepieg vrkhmcnW" pbueeeftheleb. . . . . 6. .lbe.lleuamota - kxt6e• .hVW+WdBretlowi4Yaetbernou4udrob.. perdtNr.aoru~OWOval e4W~vbYtN~dlhe . prev4bu ar~nYO[her hw.'ukorn[abtlon. . . . . . SICd7WDATE . . . Tuesday, May 17, 2005 Page i of i WHEA COMMUNITY DEVELOPMENT DEPARTMENT o~ BUILOING INSPECTION L1NE - 303-234-5933 ~ ~ CITY OF WHEAT RIDGE " ^ 7500 WEST 29TH AVENUE WHEAT RIDGE, CO 80033 - (303-235-2855) APPLICATION rroperryO..2,er: DeS~$~~ ~SL..! Property Address: c4-'7- } 1 Ma r51,~11 ~ Contractor License No.: Phone: 3Q 3 - 424 - 283 CortTany: M dGA f~ Phone: 363 - 915- - 2 4 9'~- OWNER/CON7RACTOR SIGNATURE OF UNDERS7ANDIN6 ANO AGREEMENT 8uildina Dept Valuafion Figuie: 1 hereby certify that the setback Cistances proposed by this permit applitafion are accu2le, and do rwt violate apptipbk adinances, rules a repuWtions M Me City of Wheal Ridye or oovenants. easements d resUictions of reoord: thataM meawremenb shown, and aNepations ma0e are acwra4; that I have rea0 and agree b abide by all conditions prinfed on thia applica0on and that I aswme full responsibility fa comDliance with the Wheat Ridpe Buildirro Code (I.B.C)a~ N appiicable Wheat Ritlpe Ordinancea, for work un ' peRnit. PI, ~s subia6l to fi d inspectio~. ~ / 7 . (OWNER)(COMiUCTOR):PfiINTED DATE v2lllC:$ ' Permit Fee:$ 14-a qo Plan Review Fee:$ Use of Space (description): Descriptlonofwork: °-t-`,5 ~a t Sq.Ft.addod Use Ta~c:$ /CXV Total: a6`7- ~GO.no slt~ EAC',; h,,IJ, BUII.DING DEPARTMENT USE ONLY SIC: Sq.Ft.: COAMIENTS: npp.ovac Rip7NE ENERG Zoniny: P MINIMUM OF 900/0 CTOR ic caan~r+rs: ~~LERNEI'FUR pTERSAA MINIMUM Of .60 ENERG FACTOR p~ M►ATER p MINIMUM OF .93 ENE IC HEAT) Avwnv'ac ~ ~ yyA7ER FIFA7ER5 19 CRAW CES waacs ca.a+Enrs: R-2~ MML~: • R~ Approval: ApPnDV21: CdAMENTS: Walls: Roof: Stories: Residential Units: ElecVical License No: Plumbing License No: Mechanical License No: Company. Company. Company. Expiration Date: Expi2tion Date: Eupiration Date: Approval: Approval: Approval: (1) This pemil waa isated'm accadance with the povisbna xt foM in your applicaUOn and ia subjeA b ihe laws of Uhe State of Cobrado and b the Zonirg ReputaEOns and Buddirq CoOes W Wfaat RiOqe. CobraAO w any o1Mr applicable ordinances of me CHy. (2) This Dermft ahall expire H(A) Ihe wdk auUmrixe0 iE ral commenoetl wdtliin sixty (90) daya from iswe date w(B) the building autlarized is wapended ar abandoned M a period of 780 days. (3) If Mis pennft nxpires. a new Dsrtnit may be acyuire0 for a fee ot ane-heM 1M amount namally roQureE. Pmvitled ra tlianges have Deen orwip be rtmAe in Ihs Oripinel DWns and apetififati0ns and anY wspensian a abandafinent has not "ceeded one (1) Year. B duarges have been a if auspenaion a aDaMonmsM eaceeds one (1) Ypr, lu6 fess ahaA be paid f« a new permiL (4) W wofk o1 arry m9nner sheY be dons thet vW tfiarps CM na4aiil Ibw of wetar nwinq e drauiape piobkm. (5) Contrscbr aha6 no9h tlw &dldvq b+sPecbr lwsrnY-tpr (24) tiars in advanoe for all inspectiau arid ahail receive written appreval on Mpsction cwd Cefors ProceedY+y witli succeaaire phaaea of Uhe joD. (6) The issuarwe W a psrmR a tlx approral 01 drawirqs ard apsdRcations shaY not bs conatrued b be a permit ta. rror an appwal of. a^Y vidatlon oT Me provisions of Ms W+ildin9 codea or arry otAer ordinance, law, rub a reWidaEm. NI plan rnMw Is sAabjM to MM iropectbm. Chief Building Official Building Permit Number: Date: ~I / (01 Q ,s