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HomeMy WebLinkAbout4677 Estes StreetINSPECTION RECORD INSPECTION ONLINE FORM: http://www.ci.wheatridge.co.us/inspection INSPECTION REQUEST LINE: (303) 234-5933 Occupancy/Type 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 Comments Initials Electrical Sewer Service Plumbing 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 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. *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 Until A Certificate of Occupancy Is Issued Protect This Card From The Weather City of Wheat Ridge If r -u 4vo Residential Roofing PERMIT - 201704541 PERMIT NO: 201704541 ISSUED: 07/20/2017 JOB ADDRESS: 4677 Estes ST EXPIRES: 07/20/2018 JOB DESCRIPTION: Residential Re -roof to install owens corning duration storm asphalt shingles with 20 sq house pitch 4/12 *** CONTACTS *** OWNER (303)423-9311 HARRIS WILLIAM PAUL SUB (303)425-7531 John Borfitz 019983 J & K Roofing Inc. *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2002 / KIPLING, I-70 & CLEARCREEK ARE BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 6,928.00 FEES Total Valuation 0.00 Use Tax 145.49 Permit Fee 156.75 ** TOTAL ** 302.24 *** COMMENTS *** *** CONDITIONS *** Effective December 1, 2014, asphalt shingle installations require an approved midroof inspection, conducted when 25-75 percent of the roof covering is installed, prior to final approval. Installation of roof sheathing (new or overlay) requires an approved inspection prior to installation of ANY roof coverings and is require on the entire roof when spaced or board sheathing with ANY gap exceeding one half inch exists. Asphalt shingles are required to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield is required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave and secured in place is required to be provided for all roof inspections. Roof ventilation is required to comply with applicable codes and/or manufacturer installation instructions, whichever is more stringent. In order to pass a final inspection of elastomeric or similar type roof coverings, a letter of inspection and approval from the manufacturer technical representative stating that "the application of the roof at (project address) has been applied in accordance with the installation instruction for (roof material brand name) roof covering" is required to be on site at the time of final inspection. Roof inspections for ROOFS OVER 6/12 PITCH: 3rd party inspection will be required, the 3rd party inspection report will be collected at final roof inspection performed by City of Wheat Ridge. If report is not available the final inspection will not be completed. City of Wheat Ridge Residential Roofing PERMIT - 201704541 PERMIT NO: 201704541 ISSUED: 07/20/2017 JOB ADDRESS: 4677 Estes ST EXPIRES: 07/20/2018 JOB DESCRIPTION: Residential Re -roof to install owens corning duration storm asphalt shingles with 20 sq house pitch 4/12 *** CONTACTS *** OWNER (303)423-9311 HARRIS WIT LIAM PAUL SUB (303)425-7531 John Borfitz 019983 J & K Roofing Inc. *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2002 / KIPLING, I-70 & CLEARCREEK ARE BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 6,928.00 FEES Total Valuation 0.00 Use Tax 145.49 Permit Fee 156.75 ** TOTAL ** 302.24 *** COMMENTS *** *** CONDITIONS *** Effective December 1, 2014, asphalt shingle installations require an approved midroof inspection, conducted when 25-75 percent of the roof covering is installed, prior to final approval. Installation of roof sheathing (new or overlay) requires an approved inspection prior to installation of ANY roof coverings and is require on the entire roof when spaced or board sheathing with ANY gap exceeding one half inch exists. Asphalt shingles are required to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield is required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave and secured in place is required to be provided for all roof inspections. Roof ventilation is required to comply with applicable codes and/or manufacturer installation instructions, whichever is more stringent. In order to pass a final inspection of elastomeric or similar type roof coverings, a letter of inspection and approval from the manufacturer technical representative stating that "the application of the roof at (project address) has been applied in accordance with the installation instruction for (roof material brand name) roof covering" is required to be on site at the time of final inspection. Roof inspections for ROOFS OVER 6/12 PITCH: 3rd party inspection will be required, the 3rd party inspection report will be collected at final roof inspection performed by City of Wheat Ridge. If report is not available the final inspection will not be completed. City of Wheat Ridge Residential Roofing PERMIT - 201704541 PERMIT NO: 201704541 ISSUED: 07/20/2017 JOB ADDRESS: 4677 Estes ST EXPIRES: 07/20/2018 JOB DESCRIPTION: Residential Re -roof to install owens corning duration storm asphalt shingles with 20 sq house pitch 4/12 I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this permit. I further attest that I am legally authorized to include all entities named within this document as parties to the work to be performed and that all work o be performed is disclosed in this document and/or its' accompanying approved plans and specifications. Signature of O �F�R� or CONTRACTOR (Circle one) Date I. This permit w 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 androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Offcial 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 re uired inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or granting of a permit shall not be construed to be a permit for or an approval of, any violation of any provision of any applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief Building Officials O"' — f3afe -- 0 REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Dan Schultz �L From: no-reply@ci.wheatridge.co.us Sent: Wednesday, July 12, 2017 9:35 AM To: Permits CommDev Subject: Online Form Submittal: Residential Roofing Permit Application Categories: Gina Residential Roofing Permit Application This application is exclusively for new permits for residential roofs and for licensed contractors only. This type of permit is ONLY being processed online --do not come to City Hall to submit an application in person. Permits are processed and issued in the order they are received and due to the volume of requests, time to process varies and is subject to change. YOU WILL BE CONTACTED WHEN YOUR PERMIT IS READY FOR PICK-UP AND WILL BE GIVEN A SPECIFIC DATE AND TIME WINDOW TO COMPLETE THE TRANSACTION. You will be notified if your contractor's license or insurance has expired, and you may update those documents at the time you are issued your permit. For all other requests: Homeowners wishing to obtain a roofing permit must apply for the permit in person at City Hall. Revisions to existing permits (for example, to add redecking) must be completed in person at City Hall. All other non -roofing permits must be completed in person at City Hall. The Building Division will be open from 7:30-10:30 a.m., Monday through Friday to process these types of requests. THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN REROOFING UNTIL PERMIT HAS BEEN ISSUED. Is this application for a Yes residential roof? How many dwelling units Single Family Home are on the property? PROPERTY INFORMATION Property Address Property Owner Name Property Owner Phone Number 4677 Estes St William Harris 303-423-9311 Property Owner Email Field not completed. Address 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 J&K Roofing Contractor's License 019983 Number (for the City of Wheat Ridge) Contractor Phone 303-425-7531 Number Contractor Email Address kathyv@jkroofing.com Retype Contractor Email kathyv@jkroofing.com Address DESCRIPTION OF WORK Are you re-decking the No roof? Description of Roofing Owens Corning Duration Storm Material Select Type of Material: Asphalt If "Other" is selected Field not completed. above, describe here: How many squares of the 20 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 20 roofing material for this project Provide additional detail House - 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 6928 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 Kathy Vendegna Email not displaying correctly? View it in your browser. 3 r CONTRACT J&K Roofing BBB 13000 W. 43rd Drive • Golden, CO 80403 �2 Phone: 303-425-7531 • Fax: 303-425-1562 www.jkroofing.com Representative (- �f ` ` L --t, Contact :z '-zx/ Date 20/7 Name %iz�r�,.,�/I Phone email Address _A77 &AA City 4/1As Zip, Pinnacol Assurance Cincinnati Specialty Underwriters 303-361-4000 303-653-0023 Workers Compensation Insurance General Liability Insurance Policy #4079290 Policy #CS00061742 LABOR AND MATERIAL SPECIFICATIONS, TERMS, IbExtra work AND CONDITIONS. PLEASE READ CAREFULLY: j JI Recover roof with �XOlor of shingles 4D manufacturer's /W_arranty Tear off Install Underlaymertt + Double all Eaves 1 Re-Flashhimne and or Skyl' hts New Valleys Replace Ridge Ventilation r f,1 Galvanized Fasteners Replace y Plumbing Jacks Paint roof stacks to match ' Y A31nstall I etal Edging i Patio or Flat roof 10 ;5- Year Warranty on labor J & K Roofing to furnish all material nd labor A3 Permit: _ rj — Included NOT Included Xplean-up debris and haul off all trash from roof I 'Roll yard with magnetic roller 'Gutters cleaned of roofing debris !^ Decking Repairs $ per L Hidden Layers (tear off) (Carrier; $ perlayer *A &rQLA� The property owner is is not using proceeds from property and casualty insurance policy. $ $ Deductible if applicable $ Per Colorado State Law CRS § 6-22-105 which states; 100% the responsibility of the homeowner to pay this amount. J & K Roofing will not reimburse or promise to reimburse in whole or in part any amount of the deductible. Estimated Start Date Gt' TOTAL ESTIMATE $,IG�[.��r• ALL PROPOSALS PROPOSALS ARE SUBJECT TO MANAGEMENT APPROVAL 7 J & K Representativ oll 1�omeownert"i 9 - ?16!� Date,/- taaim #) (Adjustor) Homeowner ,Mortgage Co.) (Mortgage Loan Number) Expiration Date Date You have the right to recind this contract and obtain a full refund of any deposit within 72 hours after entering the contract. If you plan to use the proceeds from a property and casualty insurance policy to pay for the roofing work, you may rescind this contract within 72 hours after receiving written notice from your insurance carrier that your claim has been denied in whole or in part. However, J & K Roofing is entitled to retain payments or deposits to compensate for roofing work actually performed in a workmanlike manner consistent with standard roofing practices. PLEASE SEE REVERSE SIDE FOR IMPORTANT INFORMATION 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: �Lr Job Address: `1&-7% % s Permit Number: -7 cl7G 11 T `� l ❑ No one available for inspection: Time J �M/PM Re -Inspection required: Yes (N� When corrections have been made, call for re -inspection at 303 -234 - Date: f ij Inspector: r� 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: Job Address: -S Permit Number: ❑ No one available for inspection: Time �- S S' AM/cl Re -Inspection required: Yes Op ; When corrections have been made, call for re -inspection at 303-234-5933 Date: _;�' e7F' 17 Inspector: � DO NOT REMOVE THIS NOTICE City of Wheat Ridge Residential Mechanic PERMIT - 201601809 PERMIT NO: 201601809 ISSUED: 11/15/2016 JOB ADDRESS: 4677 Estes ST EXPIRES: 11/15/2017 JOB DESCRIPTION: Replace Furnace with 80 °s *** CONTACTS *** OWNER HARRIS WILLIAM PAUL GC (303)418-6001 ARS 021694 ARS (Mechanical) *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: / SUBDIVISION CODE: 2002 / KIPLING, I-70 & CLEARCREEK ARE BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 3,000.00 FEES Furnace Replacement 40.00 Total Valuation 0.00 Use Tax 54.00 ** TOTAL ** 94.00 *** COMMENTS *** *** CONDITIONS *** All work shall comply with applicable codes and ordinances and is subject to field inspections. 1, by m signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am [die legal owner or have been authorized bye legal owner of the property a uthorized to obtain this permit and perform the work described and approved in conjunction with this permit. I furt [test t m le ally uthorized to include all entities named within this document as parties to the work to be performed and at I w to be perfo is disc ed in this document and/or its' accompanying approved plans and specifications. Signature/ OWNER or COfd`i•IMACTOR (Circle one) Dafe 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 I 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 ermit fee. 3. If this permit expires, a new pen -nit 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 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 ho der 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 perm it for, or an approval of, an violation of any provision of any applicab�code or any ordinance or regulation of this jurisdiction. Approval,,6f work is subject to field inspection. I/ SignatuM of Chief UIding Official Date REQUESTS MUST BE E 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 insptime@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. City of � WheatPidge COMMUNITY DEVELOPMENT PARK) Building & Inspection Services Division4 7500 W. 291h Ave., Wheat Ridge, CO 80033 aEb Office: 303-235-2855 ; Fax: 303-237-8929 Inspection Line: 303-234-5933 FOR OFFICE USE ONLY Date: Planmennit Ile J' a 6I C© 170 9 Plan Review Fee: Building Permit Application ' Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. "' Property Address: Property Owner (please print): bi 141 S Phone:- Property Owner Email: Mailing Address: (if different than property address) Address City, State, Zip: Arch itect/Engineer: Architect/Engineer E-mail: Phone: Contractor: 5 Contractors City License #: 0 Contractor E-mail Address: Sub Contractors: Electrical: f ` Jw W.R. City License # /))b 3V 9 Other City Licensed Sub: City License # Plumbing: W.R. City License # Phone: Other City Licensed Sub: City License # Mechanical: W.R. City License # Complete all information on BOTH sides of this form Description of work: (Check all that apply) ❑ NEW COMMERCIAL STRUCTURE ❑ ELECTRICAL SERVICE UPGRADE ❑ NEW RESIDENTIAL STRUCTURE ❑ COMMERCIAL ROOFING ❑ COMMERCIAL ADDITION ❑ RESIDENTIAL ROOFING ❑ RESDENTIAL ADDITION ❑ WINDOW REPLACEMENT ❑ COMMERCIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.) ❑ RESIDENTIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.) ECHANICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT PLUMBING SYSTEM/APPLIANCE REPAIR or REPLACMENT ❑ ELECTRICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT ❑ OTHER (Describe) (For ALL projects, please 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. FULF Amps Btu's Squares Gallons Other Project Value: (Contract value or the cost of all materials and labor included in the entire project) 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 applicatio o ist tha t' on this application. CIRCLE ONE: (OWNER) ( or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) PRINT NAME: L I � / SIGNATURE: DATE: 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 Sariit8tion District 11 Received 11 Not Required DEPARTMENT USE ONLY OCCUPANCY CLASSIFICATION: Building Division Valuation: $ ,',,' ~""e.",'--~" ,,' ,-".__.,..~,Ulljll, U~"k'" . _,,_..~...lll~__ "''':. w'.\"~""""'T'__..~,.l!I~ City of Wheat Ridge Residential Roofmg PERMIT - 070880 PERMIT NO: JOB l\Pl:)RESS: DESCRIP'l'ION: 070880 4677 ESTES ST '1'/0 to deck; install 19 sqs. ISSUED: 08/21/2007 EXPIRES: 02/17/2008 of 40 yr dimensionals. .~. CONTACTS ... owner 3D2/423-9111 gc 303/678-7828 William Harris 02-1770 Roof Check Inc. - ** PARCEL INFO ZONE @E: SUBDIVISION: u UA 0215 USE: BLOCK/LOT#: UA 0/ - .. FEE SUMMARY.' ESTIMATED PROJECT VALUATION: FEES l:::H 1k~~kID 189.54 3,502.00 Permit Fee Total Valuation Use Tax ** TOTAL ** - ..Comments: 6 nail required on roof inStallation. I h<9rebycerHfy thatt~esetback distances proposed by this permit application are accurate, and do not violate applicable ordinanc.s, rules or regUlations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all mea;suretnents shown, and allegations made are accurate; that I have read and agree to abide by all conditions printed on this applica~i~n and that r aSsume full responsibility for compliance with the Wheat Ridge Building Code (r.B.C) and all other ~l1C le Wheat Ri eOrdinances, for work under this permit. plans subject to field inspection, 1. 'rhis'Pr 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 ZoniIig Regulations and Building Codes of Wheat Ridge, Colorado or any other applicable "rdinances of the City. 2. 'rhia'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. 3. If thi,spermitexpires, a .new permit may be acquired for a fee of one-half the amount normally required, provided no '::hang.,a have been or will be made in the original plans and specifications and any suspension or abandoM:lent has not 'exceiEl~one (1) year. If changes have been or if suspension or abandonment exceeds one (1) year, full fees shall :oe p,aidfor a new,-permit. 4. )10 ~~~Of any manner shall be 'done that will change the natural flow of water causing a drainage'problem. 5. Contractor Bhall notify the Building Inspector twenty-four (24) hours in advance for all inspections and shall receive writ~en approval on inspection card before proceediIig with successive phases of the job. 6. 'rhe isstiance of a permit or the approval of drawings and specifications shall not be construed to be a permit for, nor ,m approval of, an olationof the provisions of the building codes or any other ordinance, law, rule or regulation. .~ll p1-'aJl. r i ject to field inspections. Sign.;l.tu~.--of date INSPS4'I.'X REQUESTS RBQUBST L!NB. (303)234-5933 BUILDING OFFICE: (303)235-2855 MUST BE MADE BY 3PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. AUG-10-2007 MON 09:45 AM p. 002/002 a 1.. "'>I' <;'....,.., " ---- " City of Wheat Ridge Building Division 7500 W. 29th Ave., Wheat Ridge, CO 80033 Office: 303-235-2855. Fax: 303-235-2857 Inspection Line: 303-234-5933 Date: PIBn#: Permit #: Building Permit Application Property Address: Jd loll ~-\-r: <; S' -tv ~ ~ +- Property Owner (please prinO: VI! ,\ \ \'(). rn \-\OlVyis. Phone: 303 L{'23C(3} I Mailing Address: (if different than property address) Address: City, State, Zip: Co ntractor: \2-0 On GG \:::: ~ \'1'1 () \V\G Contractor License #: Sub Contractors: Electrical City License #: Com pany: Plumbing City License #: Company Mechanical City License #: Company: Exp, Date: Approval: Exp, Date: Approval: Exp, Date: Approva I: Use of space (description): 5 ~ Conotrucllon Value: $ . OQ Description of w~: (as calculatod p., tho Building Valuation Dote sho.tl ~V" 0 3-\-O..1?$ dO\.Nf"lW Plan Rovlow (du..tnmo olsubm/JtaJ): $ M.c\::'n~* \Y\~LA \"It) oPL\O.:Jr" \MCN'lon S. Sq, FtiL.Ft added: Squares BTU's Gallons _ Amps _ OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setblJck distanceS propo5ed by this permit application are accurate, and do not violate applicable ordinances, rules 0' regUlations of the CIty of v\tuaat Ridge or covanarrts, easements, or restrictions of record: that all measurements ShOlNl'l, and alllEl:gatlons made a,re aCClJratlEl:; that I have read and agraQ to abide by aU conditions prlnted on this application and that I a,ss,ume full l"Nponslblllty for compliance wlth the Wheat Ridge BuildIng Code (I.B.C) and all olher applicable Wheat RIdge OrdInances, for work under thIs permit. PI"m~ !iubJect to field In!ipectlon. CIRLCE ONE:' ~tB.6.CfeRror PERSONAL RE~R PRINT NAME: YCWGllATURE: R) ate <O.'2fb.C DEPARTMENT USE ONLY zONING COMMENTS: Zoning: Reviewer: PUBl.IC Vl,QRK$ COMMENTS: Revlewer. BUILDING DEPARTMENT COMMENTS; Revie1Ner: P"IRE: OI:PARTMENr: CJ approved WI comments 0 disapproved 0 no r&1I19W tElqulted I Bldg Valuation: $ OCCUPANCY