HomeMy WebLinkAbout4760 Dudley StreetINSPECTION RECORD
Inspection online form: http://www.ci.wheatridge.co.us/inspection
Cancellations must be submitted via the online form before 8 a.m. the day of the inspection
Inspections will not be performed unless this card is posted on the project site
Request an inspection before MIDNIGHT (11:59 PM) to receive an inspection the following business da
PERMIT: 12 - ADDRESS: y
JOB CODE: k4{_
Foundation Inspections Date Inspector
102 Caissons /Piers Initials Comments
103 Footing / P.E. Letter
104 Foundation Setback Cert.
105 Stem Walls
106 Foundation wall Insulation
Do Not Pour Concrete Prior To Approval Of The Above Inspections
Underground / Slab Inspections Date Inspector
201 Electrical /Cable/ Conduit Initials Comments
202 Sewer Underground Int.
203 Sewer Underground Ext.
204 Plumbing Underground Int.
205 Plumbing Underground Ext.
206 Water Underground
Do Not Cover Underground or Below / In -Slab Work Prior To Approval Of The Above Inspections
Rough Inspection
301 Rough Framing
302 Wall Sheathing
303 Roof Sheathing
304 Sheer Inspection
305 Insulation
306 Mid -Roof
307 Metal / Lath / Stucco
308 Rough Electrical Residential
309 Rough Electrical Commercial
310 Electrical Meter Residential
311 Electrical Meter Commercial
312 T.
Const. Meter
313 Rough Plumbing Residential
314 Rough Plumbing Commercial
315 Shower Pan
Date I Inspector
a --7r )7
a-77- i 7
SEE OVER FOR ADDITIONAL INSPECTIONS
Comments
)ERMIT:ADDRESS:
:)uah Inspection (continued)
. - .-, _ _ . _� n RPQI(1PnTiai
17 Rougn iviecnai w
18 Boiler / Furnace
. - . i_a +onl[
20 Drywall screw and Nail
— k A-:-.. rn hnnrri / Chnwpr walls
122 Rougn vraairn
JOB CODE:
Inspector
Comments
sinal inspections Date Initials
402 Gas Meter Release
403 Final Electrical Residential
404 Final Electrical Commercial
405 Final Mechanical Residential
406 Final Mechanical Commercial
407 Final Plumbing Residential
408 Final Plumbing Commercial
409 Final Roof -®
410 Final Window/Door
Inspections from these entities shall be requested
411 Landscape/Park/Planning*
one week in advance.
412 Row/Drainage/Public Works**
*For landscaping and parking inspections please
413 Flood plain Inspection**
call 303-235-2846
**For ROW and drainage inspections please call
414 Fire Insp. / Fire Protection***
303-235-2861
415 Public Works Final**
***For fire inspections please contact the Fire
416 Storm Water Mgmt.**
Protection District for your project.
417 Zoning Final Inspection*
418 Building Final Inspection
Note: All items must be completed and approved by Planning, Public Works, Fire and Building
Approval of the Final Building Inspection does not
before a Certificate of Occupancy is issued.
constitute authorization of occupancy.
For Low Voltage permits please be sure that rough inspections
are completed by the Fire District and
Electrical low voltage by the Building Division.
Do
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: Ll C `?
Job Address: Ll -7 t� ti � V cl ),e C.4 S4 --
Permit Number: a 1-7 o-7 a 3 L
❑ No one available for inspection: Time Q� = s �gPM
Re -Inspection required: Yes No
''When corrections have been made, call for re -inspection at 303 -234 -
Date: is LS A i Inspector: '76
DO NOT REMOVE THIS NOTICE
City of Wheat Ridge
Residential Roofing PERMIT - 201709234
PERMIT NO: 201709234 ISSUED: 11/22/2017
JOB ADDRESS: 4760 Dudley ST EXPIRES: 11/22/2018
JOB DESCRIPTION: Re -roofing house and both sheds with asphalt Certainteed shingle. Pitch is
4/12 and total number of squares is 24.
*** CONTACTS ***
OWNER (303)512-3444 MODER DOUG E
SUB (303)993-2862 Luis Canales & Richard Garcia 150257 Roof Evolution LLC
*** 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: 7,440.00
FEES
Total Valuation 0.00
Use Tax 156.24
Permit Fee 172.60
** TOTAL ** 328.84
*** COMMENTS ***
*** CONDITIONS ***
Midroof & Final Roof inspections for ROOFS 6/12 PITCH & OVER: 3rd party inspection will be
required for both the midroof and final inspections. The 3rd party inspection report AND
THE ORIGINAL PERMIT CARD needs to be dropped off to the Permit Desk at the City of Wheat
Ridge. The report MUST BE SIGNED by the Homeowner.
REGARDING ROOF VENTILATION: Roof ventilation shall comply with IBC Sec. 1203.2 or IRC Sec.
R806. The installation of ridge venting requires the installation or existence of soffit
venting. For calculation purposes, one hat or turtle vent equal to one-half of one square
foot of opening.
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.
A 1r City of Wheat Ridge
o r
Residential Roofing PERMIT - 201709234
PERMIT N0: 201709234 ISSUED: 11/22/2017
JOB ADDRESS: 4760 Dudley ST EXPIRES: 11/22/2018
JOB DESCRIPTION: Re -roofing house and both sheds with asphalt Certainteed shingle. Pitch is
4/12 and total number of squares is 24.
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 t al own r of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with
this pe ither attest that 1 am leggally authorized to include all entities named within this document as parties to the work to be
per or d that all o be erformed is disclosed in this document and/or its' accompanying approved plans and specifications.
Signature of OW or�ONTRACTOR (Circle one) Daie
1. This permit was issued based on the information provided in the permit application and accompanying Flans 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 da s 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 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 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 iss nce 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 an; ordie 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.
Kimberly Cook (�)O / q n 9 c;� 3
From: no -reply@ ci.wheatridge.co.us
Sent: Tuesday, November 21, 2017 IS6 PM
To: CommDev Permits
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 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.
y
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 (enter WITH
dashes, eg 303-123-4567)
Property Owner Email
Address
4760 Dudley Street
Doug Moder
303-512-3444
Field not completed.
Do you have a signed Yes
contract to reroof this
property?
Applications cannot be
submitted without an
executed contract
attached below.
Attach Copy of Executed moder cc.pdf
Contract
CONTRACTOR INFORMATION
Contractor Business Roof Evolution
Name
Contractor's License 150257
Number (This is a 5 or 6
digit number for the City
of Wheat Ridge)
Contractor Phone 303-993-2862
Number (enter WITH
dashes, eg 303-123-4567)
Contractor Address 5696 S. Cedar St
(Primary address of your
business)
Contractor Email Address roofevolution@gmail.com
Retype Contractor Email
Address
DESCRIPTION OF WORK
TOTAL SQUARES of
the entire scope of work:
Project Value (contract
value or cost of ALL
materials and labor)
Are you re -decking the
roof?
Is the permit for a flat
roof, pitched roof, or
both? (check all that
apply)
roofevolution@gmail.com
24
7440
No
Pitched roof (2:12 pitch or greater)
z
What is the specific pitch
of the PITCHED roof?
How many squares are
part of the PITCHED
roof?
Describe the roofing
materials for the
PITCHED roof:
Type of material for the
PITCHED roof-
Provide
oof
Provide any additional
detail here on the
description of work. (Is
this for a house or
garage? Etc)
4/12
20
Certainteed-Asphalt Shingle
Asphalt
House and both sheds
SIGNATURE OF UNDERSTANDING AND AGREEMENT
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.
I understand that this
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
may not begin on this
property until a permit
has been issued and
posted on the property.
I certify that I have been
authorized by the legal
owner of the property to
submit this application
Yes
Yes
Yes
Yes
3
and to perform the work
described above.
I attest that everything Yes
stated in this application
is true and correct and
that falsifying
information in this
application is an act of
fraud and may be
punishable by fine,
imprisonment, or both.
Name of Applicant Johnny Garcia
Email not displaying correctly? View it in your browser.
.m
la
5696 South Cedar St -- Littleton — CO — 80120 - (720) 334-7311
Roof Evolution LLC Liability Insurance Contact — RKA Insurance Services — (303) 374-0753
CONTRACT CONFIRMATION
CUSTOMER: Douqlas Moder
STREET: 4760 Dudley St
CITY: Wheat Ridge STATE: CO zip: 80033
PHONE #: 303-512-3444 EMAIL: N/A
SPECIFICATIONS:
Manufacturer: Certainteed
Style of shingle: Northgate
Color of shingle: Resawn
Color of Drip Edge: IVOry
Color of Gutter: Sandstone
Repairs:
TOTAL CHARGE FOR ABOVE LISTED WORK IS:
PAYMENT SCHEDULE IS AS FOLLOWS:
Number of Squares: 23.33 Home and two Sheds and 3.60 of Modified
Notes: All work to be done per Insurance Estimate and Roof
Evolution Estimate, Roof on Home, Shed 1, Shed 2, Flat
Roof, Gutters and Downspouts. Permit Fee is not included
that will be sent to State Farm for supplement
Customer only responsible for deductable
$ 18.557.76
1'* Payment (upon material delivery): $ 7775,26
Remaining Balance (upon completion of work): $ 10, 782.50
SOMETIMES SUPPLEMENTS ARE REQUIRED ON YOUR JOB IN ORDER TO COMPLETE THE WORK: Potential supplements
include, but are not limited to re -deck, building permit, additional ventilation, ridge cap, and additional material. You
understand that these supplemental items may be required by your Building Ordinence. By signing, you agree to allow
Roof Evolution LLC to supplement your insurance carrier for additional funds, including overhead & profit, which are
payable to ROOF EVOLUTION LLC.
CHANGE ORDERS:During the course of construction there may be changes that incur, this will be considered a change
order and the base contract price will adjust accordingly. The person who signs the contract will be responsible to sign
all change orders or provide written confirmation.
a1
AUT 1RIZED Y:
Homeowner Date Homeowner Date
We hereby agree to furnish labor and materials — complete in accordance with the above specifications and in conjunction with the original
contract at above stated price. Please make all checks payable to Roof Evolution U.C. Roof Evolution LLC will not be responsible for checks made
payable to any other party.
Contractor
APPROXIMATE START DATE 10/20/2017
APPROXIMATE COMPLETION DATE:11/1112017 Weather Pendinc
Date
AW VL HOOFING PNnHecrs
e41
ROOF EVOLUTION p
LLC BBB.
_ 9
5696 S Cedar St Littleton -- CO — 80120 (Office) 303-993-2862 (Cell) 720-334-7311
Roof Evolution LLC Liability Insurance Contact— RKA Insurance Service— 303-374-0753
AGREEMENT
THIS AGREEMENT IS SUBJECT TO INSURANCE COMPANY APPROVAL OF PAYMENT
CUSTOMER I a c ie.11 INSURANCE CO.
STREET ip acp/e, CLAIM
CITY_ i.�'''t ST 60 ZIP M.33
7 2_-
� J� APPROXIMATE DOLLARS (Cost for same based on damages
HOME., 5 ' q2 - CELL know=n at time this agreement is entered into):
E-MAIL ADDRESS
ROOF REPLACEMENT SPECIFICATIONS
bb TYPE OF TILE / SHINGLE��
STYLE OF TILE/ SHINGLE
@� COLOR OF TILE / SHINGLE _ /� ���2 0' Y1
VALLEY 2- EK PITCH {Z El2 STORY
J- TEAR OFF ALL LAYERS %
tT�,PERMIT FURNISHED E& PROTECT LANDSCAPE
6 REMOVE ROOF TRASH FROM ROOF, GUTTERS & YARD
a-ROLLYARD WITH MAGNET ROLLER
TERMS:
APPROXIMATE START DATE ?,/ j 7
APPRPXIMATE COMPLETION DATE: 912?117
ROOF ACCESSORIES TO REPLACE:
FELT LB 15 $iICE& WATER SHIELD C4Ve5.4
BOOT JACKS 3 TURTLESS BRONES
TURBINE Z- FURNACE CAP ELECTRIC
AC/SWAMP CHIMNEY RIDGE VENTC-4-4 114 $
DRIP EDGE KEEP / REPLACE -COLOR
CUSTOMER AND ROOF EVOLUTION LLC. HEREIN KNOWN AS "THE COMPANY" AGREE THAT ALL OBLIGATIONS UNDER THE AGREEMENT ARE
EFFECTIVE UPON APPROVAL OF THE AGREEMENT BY THE INSURANCE COMPANY. BY SIGNING THIS AGREEMENT THE CUSTOMER AUTHORIZES
THE COMPANY TO PURSUE THE CUTOMERS BEST INTEREST FOR PROPERTY REPLACEMENT OR REPAIR AT AN AGREED UPON PRICE TO THE
CUSTOMERS INSURANCE COMPANY AND THE COMPANY WITH NO ADDITIONAL COST TO THE CUSTOMER OTHER THAN THE INSURANCE
DEDUCTIBLE_ WITH THE EXCEPTION OF ROOF DECKING AS SEI' FORTH BELOW. WHEN "PRICE AGREEABLE" HAS BEEN DETERMINED IT SHALL
BECOME THE FINAL CONTRACT AMOUNT AND THE CUSTOMER AUTHORIZES THE COMPANY TO OBTAIN LABOR AND MATERIAL IN ACCORDANCE
WITH THAT PRICE AND SPECIFICATIONS SET OUT HERIN AND ON THE REVERSE SIDE HEREOF TO ACCOMPLISH THE REPLACEMENT OR REPAIR.
WHEREFORE THE COMPANY ACTING AS YOUR CONTRACTOR WILL BE ENTITLED TO ,ALL INSURANCE PROCEEDS IN ACCORDANCE WITH THIS
AGREEMENT. CUSTOMER RECOGNIZES THE COMPANY AS A GENERAL CONTRACTOR AND AS SUCH THE COMPANY WILL BE ENTITLED TO 10%
OVERHEAD & 10% PROFIT AS ALLOWED BY INSURANCE INDUSTRY STANDARDS. ALL WORK WILL BE PERFORMED AT INSURANCE COMPANY
RATES. FIGURES & MONEY. ALL PRICES ARE SUBJECT TO CHANGE.
THE FINAL ROOF PRICE IS THE RCV AMOUNT ON THE INSURANCE PAPERWORK PLUS THE APPLICABLE CONTRACTORS OVERHEAD AND
PROFIT.
CUSTOMER AGREES TO PAY APPLICABLE INSPECTION FEE IF THE AGREEMENT IS CANCELLED AFTER THE INSURANCE COMPANY
APPROVES PAYMENT ON THE ROOF REPLACEMENT. CUSTOMER CAN CANCEL. THE AGREEMENT ANVTIME PRIOR TO MIDNIGHT ON THE
THIRD BUSINESS DAY AFTER EXECUTION OF AGREEMENT AND OPTAIN FILL REFt'ND OF ANY DEPOSITS. CUSTOMER MAY RESCIND THIS
AGREEMENT FOR, THE PAYMENT. FOR WHICH SHALL BE MADE FROM THE PROCEEDS OF THE PROPERTY INSURANCE CLAIM. WITHIN 72
HOURS AFTER RECEIVING NOTICE FROM YOUR INSURER THAT THE CLAIM IS DENIED IN WHOLE OR PART.
ROOF EVOLUTION LLC SHALL HOLD IN TRUST ANY PAYMENT FROM THE CUSTOMER UNTIL. ROOF EVOLUTION LLC HAS DELIVERED THE
ROOFING MATERIAL TO THE JOBSITE OR HAS PERFORATED A NIAJORITV OF THE ROOFING WORK ON THE PROPERTY.
YOU, THE CUSTOMER, MAV CANCEL THIS PURCHASE AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD RUSIN ESS DAY AFI ERTHE HE DATE
OF THIS AGREEMENT.
ROOF EVOLUTION LLC, HEREIN KNOLL"N AS THE COMPANY DISCLAIMS ALL WARRANTIES. EXPRESSED OR IMPLIED WARRANTY OF
MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE EXCEPT AS SPECIFICALLY EYPRESSED ON TFIE REVERSE SIDE OF THIS
AGREEMENT.
**IF ROOF DECKING IS REQUIRED BUT NOT COVERED BY YOUR INSURANCE POLICY". IT WILL BE REPLACED AND YOU AGREE TO PAY ROOF
EVOLUTION LLC $2.25 PER SQUARE FOOT REPLACED FOR OSB DECKING AND $6.75 PER LINEAR FOOT REPLACED FOR PLANK DECKING AND
FASCIA REPAIR OR REPLACEMENT ."
ACCEPTED BY HOMEOWNERS) ON: DATE I 1 BY
CO-OWNER: DATE J ! BY
COMPANY REPRESENTATIVE: DATE 1 1 BY
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING INSPECTION LINE - (303-234-5933)
CITY OF WHEAT RIDGE
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80033 - (303-235-2855)
Building Permit Number:
Date: 10/12/2004
17877
Property Owner: DOUG MODER
Property Address: 4760 DUDLEY ST
Contractor License No, :
Company:
Phone: 424-4571
Phone:
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hemby certify that the setback distances proposed by this pennit 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 respon ility for com iance with the Wheat Ridge Building
Code (U.B.C.) and all other applicable Wet Ridge 0 . anees, for work underthi~jl'.. ~
(OWNER)(CONTRACTOR) SIGNED DATE~
Total:
$400,00
$30.55
$0,00
$8,00
$38,55
Valuation:
Permit Fee:
Plan Review Fee:
Use Tax:
Use:
Description:
CHANGE TO 200 AMP SERVICE
I!&l9
BUILDING DEPARTMENT USE ONLY
jlitillpg ~htJ~
Approval:
Zoning:
JMlstl~Co~;
Approval :.
~V\(PJ:~Com~
Approval:
Occu pancy :
SIC:
Sq, Ft:
Walls:
Roof:
Stories:
Residential Units:
Electrical License No :
Company:
Plumbing License No :
Company:
Mechanical License No :
Company:
Expiration Date:
Approval:
Expiration Date:
Approval:
Expiration Date:
Approval:
('1) This permit was issued in accordance with the provisions set forth in yopur application and is subject to the laws of the State of Colorado and 10 the Zoning
Regulations and Building Code of Wheat Ridge, Colorado or any other applicable ordinances of the City.
(:2) This permit shall expire if (A) the work authorized is not commenced within sixty (60) days from issue date or (B) the building authorized is suspended or
abandoned for a period of 120 days.
(:3) If this permit expires, a new permit may be acquired fOf a fee of one-half the amount normally required, provided no changes have been or will be made in the
original plans and specifications and any suspension or abandonment has not exceeded one (1) year. If changes are made or if suspension or abandonment
exceeds one (1) year, full fees shall be paid for a new permit.
(4) No work of any manner shall be done that will change the natural flow of water causing a drainage problem.
(6) Contractor shall notify the Building Inspector twenty-four (24) hours in advance for all inspections and shall receive written approval on inspection card before
proceediing with successive hases of the job.
(13) The issua fa pe . r theappro f drawings and specifications shall not be construed to be a permit for, nor an approval of, any violation of the
pro. the din CO_des her ordinance, law, rule or regulation.
Chief Building Inspector
Please sign Terms and Conditions on reverse side of page.
~' .H[~r."
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CO( OR/>.tP
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING INSPECTION LINE - 303-234-5933
CITY OF WHEAT RIDGE
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80033 - (303-235-2855)
APPLICATION
Q6"':)lfYlo&QR
'-f 7bO Dudlk~ Sf
Building Permit Number:
Date:
Property Owner:
Property Address:
Contractor License No.:
Phone: 303 </:7.'( l()- ? I
Company:
Phone:
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
Value:$ '1a>~
Permit Fee:$
Plan Review Fee:$
USe Tax:!!>
Total:$
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 app "cation and that I assume full responsibility for
compliance with the Wheat Ri 9 Building Code (U.B.C) and all other applicable
Wheat Ridge Ordinances. for or under this ennit.
Description: I.
C"v1:J~
+0
')60 'O"1p
~:~
OAT 1, 0
~v;ce
(OWNER)(CONTRACTOR):PRINTED
{OWNER)(CONTRACTOR}: SIGNED
Sq. Ft. added
ZONING COMMENrs:
Approval:
Zoning:
BUILDING DEPARTMENT USE ONLY
SIC:
Sq,Ft:
BUILDING COMMENTS:
Approval:
PUBLIC WORKS COMMENTS:
Approval:
Occupancy:
Walls:
Roof:
Stories:
Residential Units:
Electrical License No:
Company:
Plumbing License No:
Company:
Mechanical License No:
Company:
Expiration Date:
Approval:
Expiration Date:
Approval:
Expiration Date:
Approval:
(1) This permit was issued in accordance with the provisions set forth in your application and is subjectta the laws afthe 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 if (A) the work authorized is not commenced within sixty (60) days from issue date or (B) the building
authorized is suspended or abandoned for a period of 120 days.
(3) If this permit expires. a new permit may be acquired for a fee of one-half the amount normally required. provided no changes
have been or will be made in the original plans and specifications and any suspension or abandonment has not 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.
(4) No work af 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.
Chief Building Official