HomeMy WebLinkAbout7920 Melrose DriveFrom: no-reolvCalci.wheatridae.co.us
To: CommDev Permits
Subject: Online Form Submittal: PERMIT APPLICATION Furnace/Boiler Replacement
Date: Monday, February 7, 2022 3:03:55 PM
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PERMIT APPLICATION Furnace/Boiler Replacement
This application is exclusively for RESIDENTIAL REPLACEMENT FURNACE or
BOILER - LIKE FOR LIKE ONLY.
YOU MUST ATTACH A VALID CREDIT CARD AUTHORIZATION FORM IN
ORDER FOR THE PERMIT TO BE PROCESSED.
Your Permit will be emailed to the email address provided below once it is
processed.
THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN
WORK UNTIL PERMIT HAS BEEN ISSUED.
Is this application for a Yes
replacement residential
furnace or boiler like for
like?
PROPERTY INFORMATION
Is this Residential or Residential
Commercial?
Property Address 7920 Melrose Dr
Property Owner Name
Property Owner Phone
Number (enter WITH
dashes, eg 303-123-
4567)
Lorraine Urbana
303-423-2339
Property Owner Email terrance.goodroad@authoritybrands.co
Address
Attach City of Wheat
Ridge Electronic
Payment Form - "DO
NOT ATTACH A
PICTURE OF A
CREDIT CARD"
7920 Melrose Dr oavment form.odf
CONTRACTOR INFORMATION
Contractor Business
AUTHORITY BRANDS SERVICES
Name
Contractor's License
202184
Number (This is a 5 or
6 digit number for the
City of Wheat Ridge)
Contractor Phone
303-901-5467
Number (enter WITH
dashes, eg 303-123-
4567)
Contractor Email
terrance.goodroad@authoritybrands.cc
Address
Retype Contractor
terrance.goodroad@authoritybrands.cc
Email Address
DESCRIPTION OF WORK
What type of unit is
Furnace
being installed?
Number of BTUs
80
What is the efficiency
80
(%) of the unit?
Is the unit GAS or
gas
ELECTRIC?
Where is the furnace or
basement
boiler located (for
example, basement,
crawlspace, etc)?
Project Value (contract
5600
value or cost of ALL
materials and labor)
SIGNATURE OF UNDERSTANDING AND AGREEMENT
I assume full
Yes
responsibility for
compliance with
applicable City of
Wheat Ridge codes
and ordinances for
work under any permit
issued based on this
application.
I understand that work Yes
may not begin on this
property until a permit
has been issued and
posted on the property.
I certify that I have Yes
been authorized by the
legal owner of the
property to submit this
application and to
perform the work
described above.
I attest that everything Yes
stated in this
application is true and
correct and that
falsifying information in
this application is an
act of fraud and may
be punishable by fine,
imprisonment, or both.
Person Applying for Terrance Goodroad
Pe rm it
Email not displaying correctly? View it in your browser.
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: a
Job Address:
Permit Number:
I
❑ No one available for inspection: Time(
Re -Inspection required: Yes"`—'--)
When corrections have been made, call for re -inspection at 303-234-5933
Date: '5;��Q�, i Inspector:
DO NOT REMOVE THIS NOTICE
o s_ 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: ';tib
Permit Number: (7,.
❑ No one available for inspection: Time AM/PM
Re -Inspection required: /Y�e6_1 No
When corrections have been made, call for re -inspection at 303-234-5933
Date:--,,., 0' ;v 1 , Inspector:
DO NOT REMOVE THIS NOTICE
�=City of Wheat Ridge
Residential Plumbing PERMIT - 201901559
PERMIT NO: 201901559 ISSUED: 07/30/2019
JOB ADDRESS: 7920 Melrose Dr EXPIRES: 07/29/2020
JOB DESCRIPTION: Replacement 50 gallon, 50k BTU water heater.
*** CONTACTS ***
OWNER (303)423-2339 URBANA GARY
SUB (303)418-6001 ARS 021694 ARS (Mechanical)
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 1,500.00
FEES
Hot Water Heater 40.00
Total Valuation 0.00
Use Tax 31.50
** TOTAL ** 71.50
*** COMMENTS ***
*** CONDITIONS ***
All work shall comply 2012 International Codes, 2017 NEC (if applicable), and ordinances
adopted by the City of Wheat Ridge. Work is subject to field inspections.
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 o ,the property and am authorized to obtain this permit and perform the work described and approved in conjunction with
this permit. I further that I an leggally authorized t9 include all entities named within this document as parties to the work to be
performed an c th t`�1 v k to be pertorr ed,�is disclps din this document and/or its' accompanying approved plans and specifications.
Signature of OWAR or CONTRACMR� (dirclVone) Date
1. This permit was issued based on the information provided in the pennit 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 and procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of
the Chief Building Official and is not guaranteed.
4, No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval.
5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all 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, any violation of any provision of any
applicable code orj+jiy ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection.
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
City of
�heat�de
COMMUNITY DEVELOPMENT
Building & Inspection Services
7500 W. 29' Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929
Inspection Line: 303-234-5933
Email: permits(@ci.wheatridge.co.us
FOR OFFICE USE ONLY
Date:
Plan/Permit #
Plan Review Fee:
Building Permit Application
*** Complete all applicable highlighted areas on both sides of this form.
Incomplete applications may not be processed. ***
Property Address:
Property Owner
Property Owner Email:
Tenant Name (Commercial Projects Only)
Phone: <rnSe
Property Owner Mai 1; Address: (if different than property address)
Address: I Af 46&
City, State, Zip: 1/1 11 1 C'_W r )� A� (��(
Architect/Engineer:
Architect/Engineer E-mail:
Contractor Name:
City of Wheat Ridge License #:
Contractor E-mail Address:
For Plan Review Questions & Comments�(please print):
CONTACT NAME (please print):
CONTACT EMAIL(p/ease
Phone:
Phone: : qv — /
hone:_ �-Q_� �/ZZ - d�S-/�_?
Sub Contractors (Must provide Wheat Ridge License No & Signed Subcontractor Authorization form):
Electrical: Plumbing: Mechanical:
W.R. City License # W.R. City License # W.R. City License #
Other City Licensed Sub: Other City Licensed Sub:
City License # City License #
Complete all highlighted fields.
❑COMMERCIAL Z RESIDENTIAL
Provide description of work: For ALL projects, provide a detailed description of work to be
performed, including current use of areas, proposed uses, square footage, existing condition and
proposed new condition, appliance size and efficiency, type a d amount of materials o be used etc.
Sq. Ft./LF
BTUs CDL Gallons
Amps Squares For Solar: IMI # of Panels Requires Structural
For Commercial Projects Only: Occupancy Type: Construction Type:
Occupancy Load: Square Footage:
Project Value: (Contract value or the cost of all materials and labor included in the entire project)
$ $ /J,o 0 1
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or
regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are
accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance
with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner
or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any
entity included on this application to list that entity on this application. I, the applicant for this building permit application, warrant the
truthfulness of the information provided-enrthe-annlication.
CIRCLE ONE. (OWNER) ONCTO M�HORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR)
Signature (first and last name): DATE:
Printed Name:
DEPARTMENT USE ONLY
ZONING COMMMENTS: OCCUPANCY CLASSIFICATION:
CONSTRUCTION TYPE:
Reviewer:
BUILDING DEPARTMENT COMMENTS:
Reviewer:
PUBLIC WORKS COMMENTS:
Reviewer.
Building Division Valuation:
n /N. %t _ r\ - % 1),— '1 fi i --1 ii 1 ? I
-''VN S P E C T 1 O RECORD
INSPECTION REQUEST LINE: (303) 234-5933
Occupancy/Type
Inspector Comments
Initials
Inspections will not be performed unless th*s card is posted on the project site.
Call the inspection 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
Mid -Roof
Concrete Encased Ground (CEG)
Foundation / P.E. Letter
Lath / Wall Tie
UO Not Pour Concrete Prior To Anniroval Of The Above Insnpr_tinnc
Underground/Slab Inspections
Date
Inspector Comments
Initials
Electrical
Wall Sheathing
Sewer Service
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.
Mid -Roof
Plumbing
Floodplain Inspection (if applicable)
Uo Not Lover unnerarouno or KPlnwrin-Slah Wnrk Prier Tn Annrnval (1f The Ahnvn Incr�n�+inns
Rough Inspections
Date
Inspector
Initials
Comments
Wall Sheathing
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.
Mid -Roof
t
Floodplain Inspection (if applicable)
Lath / Wall Tie
Fire Inspection / Fire Protection Dist.
Rough Electric"
Final Electrical
Rough Plumbing/Gas Line
Final Plumbing
Rough Mechanical
Final Mechanical
Rough Framing
Roof
Final Window/Doors
Rough Grading
Final Building
Insulation
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.
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.
ror low voltage permiis — riease De sure tnat rougn inspections are completea from the Tire Uistnct and electrical low voltage
by the Building Division.
For notification of your assigned inspection time window please email itisptjinerequestLa)ci.wheatridge.co.us by 8:00 A.M.
the day of the inspection with the property address in the subject line of the email. Time windows are assigned based on
inspection routing.
Occupancy Is Nr -t P 4 - rsslled
' City of Wheat Ridge
w
Residential Roofing PERMIT - 201701825
PERMIT NO: 201701825 ISSUED: 06/09/2017
JOB ADDRESS: 7920 Melrose DR EXPIRES: 06/09/2018
JOB DESCRIPTION: Reroof with OC Duration 32 squares
*** CONTACTS ***
OWNER (303)423-2339 URBANA GARY
SUB (303)955-5348 Michelle Wilkendorf/Bryan Stil 170250 Elevation Restoration LLC
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 12,000.00
FEES
Total Valuation 0.00
Use Tax 252.00
Permit Fee 236.00
** TOTAL ** 488.00
*** 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 ven�ilation
is required to comply with applicable codes and/or manufacturer&4F''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.
i CITY OF WHEAT RIDGE
Building Inspection Division
5- (303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: k" i Q
Job Address: ? 72 C7 ?*161- 90 36 net
Permit Number: 201701 FZ S
CY fir'
❑ No one available for inspection: Time 1z' AM/PM
Re -Inspection required: Yes
When corrections have been made, call for re -inspection at 303-234-
Date:- ?4/17 Inspector: FfR
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
_��9�Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type:
Job Address: 2,q -2-Z7
Permit Number: Z_ () / 0 z�K 2,1
Re -Inspection required:��essI No
When corrections have been - ari�de, call for re -inspection at 303-234-5933
i /'
Date:
Inspector:
DO NOT REMOVE THIS NOTICE
®1 A i CITY OF WHEAT RIDGE
_:�9rBuilding Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inennrtinn Tvno- �'
❑ No one available for inspection: Time AM/PM
Re -Inspection required: Ye8 No
When corrections have been made, call for re -inspection at 303-234-5933
Date' � �1 Inspector:
DO NOT REMOVE THIS NOTICE
i CITY OF WHEAT RIDGE
_:�9�Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: g U F
Job Address: 7 2 u 0
Permit Number: 2t-1? 0lyz r
❑ No one available for inspection:' Time c) T (QM/PM
Re -Inspection required: Yes I
When corrections have been made, call for re -inspection at 303-234-5933
Date: Z111 6 7 Inspector: Kl',-
DO NOT REMOVE THIS NOTICE
City of Wheat Ridge
Residential Roofing PERMIT - 201701825
PERMIT NO: 201701825 ISSUED: 06/09/2017
JOB ADDRESS: 7920 Melrose DR EXPIRES: 06/09/2018
JOB DESCRIPTION: Reroof with OC Duration 32 squares
*** CONTACTS ***
OWNER (303)423-2339 URBANA GARY
SUB (303)955-5348 Michelle Wilkendorf/Bryan Stil 170250 Elevation Restoration LLC
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2406 / BEL AIRE,HILLCREST HEIGHTS, ME BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 12,000.00
FEES
Total Valuation 0.00
Use Tax 252.00
Permit Fee 236.00
** TOTAL ** 488.00
*** 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 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 - 201701825
PERMIT NO: 201701825 ISSUED:
JOB ADDRESS: 7920 Melrose DR EXPIRES:
JOB DESCRIPTION: Reroof with OC Duration 32 squares
06/09/2017
06/09/2018
I, byy 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 plicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized
by the legal caner of the property ar}d arra authorized to obtain this permit and perform the work described and approved in conjunction with
thispermIt. rther attest that I e a ly authorized to include all entities named within this document as parties to the work to be
per
an that all work erfored 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 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 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 o finance or reg,Li tion 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 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.
ELEVATION RESTORATION
GENERAL CONTRACTOR
2093 Montane Drive East
Golden, CO 80401
303.955.5348
BBB ♦ ♦ INSLW"CEPROCEEDSAGREEMENT
Date: f E.R Project #: E.R. Rep: JX X1,
Property Own r 111 b , Property Owner #2
Street Cell Phone
G� 0 305 -
City, State, Zip Home Phone
-5-l'al F 4?�J
Date of Loss Type of Loss
q 2�a- 7
Policy '# Work Phone
All -z/ V
Insurance Carrier Claim # Email/
SUBJECT TO: This Insurance Proceeds Agreement is contingent upon insurance carrier approval and will be NULL and VOID if an agreement
between Elevation Restoration and the Property Owner(s) insurance carrier cannot be reached. However, Elevation Restoration will invest it's time and ex-
pertise in assisting the homeowner with their insurance claim. This process will determine the cost of the work to be performed including all scope of work,
supplements, and any additional overhead and profit including the final claim amount. The homeowner's out of pocket expenses will not exceed the
deductible amount unless Property Owner(s) contracts with Elevation Restoration for additional work over and above the insurance claim. This agreement
does not obligate the Property Owner(s) or Elevation Restoration unless repairs are approved for payment by the Property Owner's insurance carrier. Upon
signature of this agreement Property Owner(s) gives Elevation Restoration express permission to work directly with their insurance carrier if applicable.
Items to be completed by Elevation Restoration: Items NOT to be completed by Elevation Restoration:
PRICE.-
X,
RICE.X, INSURANCE PROCEEDS PLUS SUPPLEMENTS PLUS OVERHEAD AND PROFIT
Insurance proceeds shall consist of entire dollar amount on the final insurance paperwork that includes all supplements requested
by Elevation Restoration including any overhead and profit, less any items not completed by Elevation Restoration.
Upon signature of this agreement it is not only reasonable and/or likely, but certain, that the property owner has hired Elevation
Restoration to perform repairs per the insurance scope, entitling Elevation Restoration to the Contractor's Overhead and Profit.
RETAIL AND/OR OPTIONS PRICE
Authorized Client
Elevation Restoration
Elevation Restoration shall hold in trust any payment received from you until
has performed a majority of the roofing work on your property.
Date: �- C/' - % .7
-11 -6
has delivered roofing materials at the site or
Page 1 of 2
Kimberly Cook a�J\Itl
01
From: no-reply@ci.wheatridge.co.us
Sent: Thursday, June 8, 2017 7:36 AM
To: Permits CommDev
Subject: Online Form Submittal: Residential Roofing Permit Application
For all other requests:
Homeowners wishing to obtain a roofing permit must apply for the permit in person
at City Hall. Existing permits that require amendments (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.
PROPERTY INFORMATION
Property Address 7920 N Melrose Dr
Property Owner Name Gary Urbana
Property Owner Phone 303-423-2339
Number �J
C —
Property Owner Email gamzly@yahoo.com
Address
Do you have a signed Yes
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
7
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 24-48 hours, 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. Existing permits that require amendments (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.
PROPERTY INFORMATION
Property Address 7920 N Melrose Dr
Property Owner Name Gary Urbana
Property Owner Phone 303-423-2339
Number �J
C —
Property Owner Email gamzly@yahoo.com
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.
7
CONTRACTOR INFORMATION
Contractor Name Elevation Restoration LLC
Contractor's License
Number (for the City of
Wheat Ridge)
Contractor Phone
Number
Contractor Email Address
(permit pick-up
instructions will be sent
to this email)
DESCRIPTION OF WORK
Is this application for a
new permit for a
residential roof?
Are you re -decking the
roof?
Description of Roofing
Material
How many squares of
material?
Provide additional detail
here on the description of
work. (Is this for a house
or garage? What is the
roof pitch? Etc)
170250
612-655-3056
bryan@elevationrestoration.com
Yes
No
Owens Corning Duration
32
Tear off and Reroof
Project Value (contract 12,000.00
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 Bryan Shiltz
Email not displaying correctly? View it in your browser.
4_INHE City of Wheat Ridge
Residential Mechanic PERMIT - 070850
PERMIT N0: 070850 . ISSUED: 08/14/2007
JOB ADDRESS: 7920 MELROSE DR EXPIRES: 02/10/2006
DESCRIPTION: Install 13seer 3 1/2 tan A/C; elect. hookup.
CONTACTS .
owner 303/423-2339 Lorraine Voss
gc 303/638-0600 Lorris Smith 07-0154 JnL Heating and air, Inc.
sub 303/423-1807 Bob Bevington 01-9206 Positively Electric
PARCEL INFO ZONE CODE: UA . USE: r-3
SUBDIVISION: 0328 BLOCK/LOT#: 0/
FEE SUMMARY ESTIMATED PROJECT VALUATION: 3,000.00
FEES
Permit Fee 108.30
Total Valuation .00
Use Tax l ~c,54.00
TOTAL 162.30 n
JDO•UD C-6h~1'
Comments: 3a
i hereby certify that the setback distances proposed by this permit application are accurate, and do not violate applicable
ordinancee, rules or regulationa ofi the City of Wheat Ridge oi covenants, easements or restrictions of record; that all
measuremente ehown, and allegation:i made are accurate; that I have read and agree to abide by all conditiona printed on this
application and that I assume full responaibility for mmpliance with the wheat Ridge Building Code (I.B.C) and all other
applicyM5le~ Wheat Rj,dge Ordinances, for work undei this permit. Plans subjec[ to field inspection.
re o£_eo~ractor/owner date
Signa
1. This s pexmit was iesued 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 Codea of Whea[ Ridge, Colorado or any other applicable
ordinancea of the City. '
2. Thia yermit ahall expire 180 days from the is8ue date. Requests for an extension mus[ be received prior to expiration
date. An extension may be grant,ed at the diecretion of the Huilding official.
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 euspension or abandonment has no[
exceeded one (1) year. If chanyes have been or if suspension or abandonment exceeds one (1) year, full fees shall
be paid for a new permit.
4. No work of any manner ahall be done that will.change the na[ural flow of water causing a drainage problem.
5. Contractor shall notify the evilding Inspectoi twenty-four (24) hours in advance for all inspections and ahall receive
written apprwal on inepection card before proceeding with successive phases of the job.
6. The issuance of permit or the approval of diawings and specifications sha11 not be construed to be a permit for, nor
an app o ny violation o`. the prwisions of the building codes or any other ordinance, law, rule or regulation.
All pl~ w is subject to field inspectiops.
Building OfficiaL aace
INSPBCTION REQUEST LINE: (303)234-5933 BUILDING OFFICE: (303)235-2855
REQUESTS MUST BE MADE BY 3PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
COMMUNITY DEVELOPMEHT DEPARTMENT Building PertnR Number:
oF ~EAr,p BUILDING INSPECTION LINE - 303-234-5933 Date:
_ a CITY OF WHEAT RIDGE
7500 WEST 29TH AVENUE pLAN #
WHEAT RIDGE, CO 80033 - (303-235-2855)
MINOR APPLICATION
PropertyOwner. t4',r fq I17L' UC"'j
eropenynaaress: 7?;k7 Afe1rzs(-,IJr, whQ~~~F,~~. rc~33 Pnona(~P~) ya3~233~'I
Contrac[or License No.: C,'7, ulSc1
~ •
Company: Phone
JY~L ~5.3, CXo
OWNERICONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT BuildlnaDevtValuationFigure: $ 7,~~ V
I hereby ceNty that the setback distances proposed by this permk application are
accurate, and do not vblate apWicabie ordinances, rules or regula6ons of the CKy of
Wheat Ridge a covenards, easemenls or restrid'ans o( record; tlua aY meesixements
shown, and aNegations made are a¢urate; that I have read and agree to abide by aN
conditions prirrted on Nis application arW that Iassume fufl iesponsbiltty fir
compliance wilh the Wheat Ridge Building Code (I.B.C) and aA WherappticaDle Wheat
Ridge Ordinances, for wak urider t"rtnit. Plarm subjed to fleld Irmpeetlon.
(owNEnx 0~r
L.
Use of Space (description):
Description of work:
37r'3 4-A 11 l3j~CP~ 3,1,4+r-.r 14,16 9.?12
Sq.Ft.added pcr') 4;ve.l~ Ele'A,-l" C)oin i~_c~nnrc~-
Value:$
Pemut Fee:$
Plan Review Fee:$
U T
Total:$
BUILDING DEPARTMENT USE ONLY
Appmval:
Zoning:
)ING COMMEMS:
Approvel:
.ic Woacs ConaErrrs:
APWOVal:
DEPAFiTMENT COMMENTS:
Approval:
)1* a s, a7
303 ~fa3 % bG
Walls: Roof: Stories: Residential Units:
Electrical License No: Plumbing License No: Mechanical license No:
Company: Company: Company:jnL F}PCCl;n34/~~r-
Expiration Date: Expiration Date: Expiration Date:
Approval: Approval: Approval:
(1) This pertnil was issued in accordance with the provisions set foAh in your applieation and is subject to the laws of the State of
Colorado and to the Zoning RegulaGons and Building Codes M Wheat Ridge, Cobrado or any Mher applicable oMinances M
ttre City.
(2) ThisPemahaiexpae180dayefianlheisauedWS.Requags loranmtwteionmuslberoceiyedPriorWenWration daBS.M
exmenaion may be 9~ rt ths Aiecretion d the 8u'16iq OlRdsl.
(3) If this permil expires, a new pertnit may be acquired fw a tee of one-haH the amount nomnalty required, provided no changes
have been or will be made in the original plans and specifications and any suspension or aban0onment has not exceeded one
(1) year. If charges have been or i/ suspension or aDandonment exceetls one (1) year, full fees shall be paid for a new pertnit.
(4) No work of any manner shall be done that will change the natural flow of water ceusing a drainage problem.
(5) Contractor shall notiy the Building Inspedor lwenry-(our (24) hours in advance tor all inspec[ions and shall receive writ[en
approval on inspectlon caid before proceeding with successive phases of the job.
(6) The issuance of a pertnit or the approval of drawings and specifications shall not be construetl to be a pertnit for, nor an
approval of, arryr violatbn of the provisans of the buiWing cotles or arry other ordinance, law, rule or regulal'wn. All plan review
is subject to field inspectloris.
L
City of Wheat Ridge
Residential Electric PERMIT - 070842
PERMIT NO: 070642 ISSUED: 08/13/2007
JOB ADDRESS: 7920 MELROSE DR EXPIRES: 02/09/2008
DESCRIPTION: Install 150A service change.
CONTACTS
owner 303/423-2339 Lorraine Voss
gc 303/423-1807 Bob Bevington 01-9206 Positively Electric
PARCEL INFO
ZONE CODE: UA USE: r-3
SUBDIVISION: 0328 BLOCK/LOT#: 0/
FEE SUNIIM7:RY ESTIMATED PROJECT VALUATION: 1,750.00
FEES
Permit Fee 82.16
Total Valuation .00
Use Tax 31.50
TOTAL 113.66
Comments
Must comply w/ 2005 NEC & 2003 IRC.
I hereby rertify that the eetback distances propoaed by this permit application are accurate, and do not violate applicable
ordinances, rulea or regulationa of the City of Wheat Ridge or covenante, easements or restric[ions of record; [hat all
meaeuremente ehown, and allega[ions made are accurate; that I have read and agree to abide by all condi[ions printed on this
application and thaG I asaume full responaibility for compliance with the wheat Aidge Building Code (I.a.C) and all other
applicable Wheat Ridge ordinancea, for wark under thie pexmit. Plans subjec[ to field inepection.
of contractor/owner date
1. This perniit was ieaued in accordance with the provisiona set forth in your application and is subject to the lawe of the
State of Colorado and to the Zoning Regulationa and Buildin9 Codes of Whea[ Ridge, Colorado or any other applicable
ordinancea of the City.
2. This petmit shall expire 180 days from the iasue date. Requesta for an extension must be received prior Co expiration
date. An exteneion may be granted at the discretion of the Huilding Official.
3. If this permit expirea, a new permit may be acquired for a fee of one-half the amount normally required, provided no
changee have been or will be made in the original plans and specifications and any suapenaion or abandonment has not
exceeded one (1) year. If changes have been or if suspenaion or abandonment exceeds one (1) year, full feee shall
be paid for a new permit.
4. No work of any manner ehall be done that will change Che natural flow of water causing a drainage problem.
5. Contractor ehall notify the Huil.ding Inepector twenty-four (24) hours in advance for all inapectiona and shall receive
written approval on inepection card before proceeding with succeeeive phaees of the job.
6. The issuance oYC' petmit or the approval of drawings and epecificatione shall not be cons[rued to be a permit for, nor
an approv/a]lqe ia violation oi' the provisiona of the building codes or any other ordinance, law, rule or regulation.
All plaq~ subject to fi.eld inspections.
Signature d~ Chi€f Hullding officia7. aace
INSPECTION RHQUEST LINE: (303)234-5933 BUILDING OEFICE: (303)235-2655
REQUESTS MUST BE MADE BY JPM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
DEPARTMENT OF PLANNING AND DEVELOPMENT Building Permit Number :
BUILDING INSPECTION DIVISION - 235-2855
CITY OF WHEAT RIDGE Date :
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80215
PropertyOwner: loe~+,aU" s
Property Address : 7 Pyo A1~~ ee,s° OA• Phone : 3-~J 3-133 Y
Contractor License No. : 1`~ ~ o L
Company : Q~ s r.~,ly All%~;c s^'• Phone : 3~Y13 iP'~ ~
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT rnstruction Value :
I hereby cartify that the setback tlistances proposed by this pertnit applieation are accurate, PQrrt11t F8B : and do not violate appliwble oMinanees, rules or regulations of the City of Wheat Ridge or
covenants, easements or restrictions of rewrd; that a11 measurements shown, and allegations lan Review Fee :
made are aeeurete; that 1 have read and agrce to abide by all conditions printed on this
application, and that I assume tull responsibiliry far comDliance with the Wheat Ridge Building Use Tax :
Code (U.B.C.) and all other applicable Wheat Ridge ordinanees, for work under this permit.
(OWNER)(CONTRACTOR) SIGNED,. DATE Total : G/• ~P'
Description: &X
BUILDING DEPARTMENT USE ONLY
~ m SIC : Sq. Ft. :
Approval :
Zoning :
Buifdina' 2C'"omme1111tsa
Approval :
P,..dHl _ ~
Approval:
Occupancy : Walls : Roof : Stories : Residential Units :
Electrical License No : 3Ss"L Plumbing License No : Mechanical License No :
Company: Company: Company:
Expiration Date : Expiration Date : Expiration Date :
Approval : Approval : Approval :
Im LP,. a ± K~a~lre~ a ILCIENRaTn!r-e~ m ~erai~3~ReWG[~l~d
(i) This permit was issueE in accortlance wiM the provisions ut forth in yopur application antl is suqect to 1M laws of the Stats W CobraOO anE to tne Zoninq
RegulaUOns antl Building Cotle af YMeat Ritlye, Cobretlo or any oMer apDlicade ortlinances ol the Ciry.
(2) This pertnil shall expire if (A) the work authonzed is not commence0 witPin sizly (80) Oays Irom issue Eate or (B) the DuilOing auNOnieA is suspenEetl or
a6antlone0 for e penoA o1120 day5.
(3) It this permit expires, a new pertnit may De acquiretl for a tee o/ one-half the amount narmally requiretl, provitleE no changes have bren or will Ee made in the
onginal plans antl specificaUOns and any suspension or a0andonment has not ezceeded one (1) yeac If changes are made or il suspension or aEanOOnmenl
eaceeES one (1) year, lull fees shall be paitl for a new permit.
(4) No vroAC ol any manner shall Oe Oone lhal will change the natu2l flow of water rausing a dreinage DroGlem.
(5) Contredor shall notiry the Builtling Inspectof twenN-four (24) houfs in atlvance (of all mspeG6on5 and 5hall retlive wntten approval on inspeGtiOn C2rtl before
proceediing wiM successive phases ol ihe 1ob.
(6) The issuance of a permit or the approval of drawings and speci(cations shall not be construed to Ee a permit for, nar an approval ol. any violation of Ne provisions
of the builtling coEes or any other ortlinance, law, rule or regula6on.
Chief Building Inspector For Mayor
THIS PERMIT VALID ONLY WHEN SIGNED BY THE CHIEF BUILDING INSPECTOR AND MAYOR
CALL: 234-5933 24 HOURS PRIOR TO INSPECTION
4HE4
City of Wh
eat Ridge Residential Fence PERMIT = 060688
PERMIT NO: 060688 ISSUED: 08/04/2006
JOB ADDRESS: 7920 MELROSE DR EXPIRES: 02/04/2008
DESCRIPTION: Replacing existing 6' privacy fence.
CONTACTS
owner 303/423-2339 Sary Urbana
PARCEL INFO
ZONE CODE: R-2 USE: R-3
SUBDIVISION: UA BLOCK/LOT#: 0/
FEE SUMMARY ESTIMATED PROJECT VALUATION: 2,400.00
FEES
Permit Fee 106.30 Pbm NOh:
Valuation .oo ~ Ig~P°nsibleforlocatingpropMy
Total 43 . 2 0 ~ CO°$~~Dg °"pTO°ements according to the
use Tax aPProved Plan and required development sand,,rds.
TOTAL 151.50 7'he City is not responsible for inaccuratc
_ .
Comments:
° p- sci ana any consttuction
e+rors resulting from inaccurate information.
KS: OK per site plan. Building in line w/ existing house.
I hereby certify that the ee[back distances proposed by this permi[ application are accurate, and do not violate applicable
ordinancee, rules or regulationa of the City of Wheat Ridge or covenante, easemen[s or restric[ione of record; that a11
measurementa ehown, and allegationa made are accurate; that I have read and agree to abide by all conditione printed on thie
application and that I asaume full responaibility for compliance with the wheat Ridge Building Code (I.B.C) and all other
applicable Wheat Ridge Ordinancee, for work under this permit. Plans subject to field inapection.
Signature of conYSactor/owner aace
1. Thie permit was iesued in accordance with [he provisione set forth in your application and is subject to the lawe of the
State of Colorado and to the 2oning Aegulatione and Building Codes of Wheat Ridge, Colorado or any other applicable
ordinancee of the City.
2. Thie pexmit ehall expire if (A) the work authorized is not commenced within six[y (60) days from iasue date or (B) the
buildi.n9 authorized ia suepended or abandoned for a period of 180 days. rovided no
3. If thi.s permit espiree, a new permit may be acquired for a fee of one-half the amount nozmally required, p
changee have been or will be made in the original plane and specifications and any euspension edLabandonment has not
full fees shall
exceeded one (1) year. If changee have been or if suspeneion or abandonment exceede one (1) y
be paid for a new permit.
5. No work of any manner shall be done that will change the natural flow of water caueing a drainage problem.
5. Contractoi ehall notify the Building Inapector twenty-four (24) houra in advance for all inspections and shall receive
written approval on inapection card before proceeding with eucceasive phasee of the job.
6. The iseuance of a permit or the approval of drawings and specifications ehall not be cons[rved to be a permit for, nor
an approval of, any violation of the proviaiona of [he building codes or any other ordinance, law, rule or regulation.
All pLan re eiub' ~''sevd inspections.
Signa f C' Buil ' icaldate
INSPECTION R8QU85T LINS: (303)234-5933 BUILDING OFFICE: (303)235-2855
REQUESTS MUST BE MADE BY 3PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
Plan Review
oE WHEqT ~ ~o City of Wheat Ridge Building Permit Number:
~ ^ Community Development Department Date:
~OL ORAO~ ~ .G~.°EId r' ~.~E\
BE~I~IS ~ tf P~'i-~~~APPLICATIR/X ♦
Property Ownei: 6.rxAJ UR "
Property Address: '?cj3U ME4Ros= AR Phone: 3 p3-/1-23-;W9
Contractor License No.:
Company: Phone:
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT Buildinq Dept. Valuation Figure: $4
I hereby certify that the setback distances proposed by this permit application are
accurate, and do not violate applicabie ordinances, rules or regulations of the City of
W heat Ridge or covenants, easements or restrictions of record; that all measurements
shown, and allegations made are acwrate; that i have read and agree to abide by all
conditions printed on this application and that I assume full responsibility for
compliance with the Wheat Ridge Building Code (I.B.C) and all other applicable Wheat
Ridge Ordinances, forwork underthis permit. Plans subJect to field Inspectlon.
SIGNE -D,1,14 /JQ'~DATE
V 31llB: $
Permit Fee:$
Plan Review Fee:$
se :
Total:$
Use of Space (description): Description of work: c cj 1sr} t,..i- il._~ -/-r~-~~-
N`~/ ` D
~
Sq.Ft.added
Expiration Date: Expiration Date: Expiration Date:
ApprovaP Approvai: Approval:
(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 WheatRidge, Colorado or anyother applicable ordinances of
the City.
(2) This permit shall expire if (A) the work authorized is not wmmenced within sixly (60) days from issue date or (B) the building
authorized is suspended or abandoned for a period of 180 days.
(3) If this permit expires, a new permit may be acquired for a fee of one-halfthe amount normally required, provided no changes
have been orwill be made in the original plans and specifcations and any suspension or abandonment has not exceeded one
(1) yeac 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 of any manner shail 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 joh.
(6) The issuance of a permit or the approval of drawings and specifcations 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. All plan review
is subject to field inspections.
Chief Building Offcial
Electrical License No: Plumbing License No: Mechanical License No:
Company: Company: Company:
t
i
~
u
, LL-
U
VN: 'L"I-
M y` M
i f I
s
S o
~
~
C
=DEPARTMENT OF PLANNING AND DEVELOPMENT Building Permit Number : 12159
BUILDING INSPECTION LINE - 303-234-5933 Date : 5/16/2001
CITY OF WHEAT RIDGE
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80215 - (303-235-2855)
Property Owner :
Property Address : 7920 Melrose Dr
Contractor License No. : 18924
Phone: 303-423-2339
Company : High Tech Roofing Co., Inc. Phone : 4200334
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 foc ompliance with the Wheat Ridge Building
Code (U.B.C.) and all other applicableJ~ ea R~ Iq~ordinances, fo rk under this permit.
(OWNER)(CONTRACTOR) SIGNED-' ~'Jw ~ DATE
Construction Value :
$3,700.00
Permit Fee :
$97 25
Plan Review Fee :
$0.00
Use Tax :
$55.50
Total:
$152.75
Use :
Description : REMOVE THE EXISTING WOOD SHAKE AND APPLY NEW 25 YEAR LAMINATED SHINGLES
1~11 1~
BUILDING DEPARTMENT USE ONLY - -
SIC : Sq. Ft. :
Approval :
Zoning :
Approval:
Approval :
Occupancy : Walls
Electrical License No :
Company :
Expiration Date :
Approval:
Roof
Plumbing License No :
Company :
Stories : Residential Units :
Mechanical License No :
Company :
Expiration Date :
Approval:
Expiration Date :
Approval :
(i) This pertnil was issued in accordance with the provisions set forth in yopur application and is su0ject to the laws of the State of Cobrado and to the Zoning
Regulations and Building Code of Wheat Ridge, Colorado or any olher applicable ordinances of the Ciry.
(2) This permit shall expire i! (A) the work authorized is not commenced within sinty (60) days from issue date or (e) the builtling authorized is suspendetl or
abandoned for a period of 120 days.
(3) If ihis pertnit expires, a new permit may be acquired for a tee of one-haif the amount normaly required, provitled no changes have been or will be matle in the
original plans antl specifications antl any suspension or abandonmen[ has not exceedetl one (1) year. If changes are made or if suspension or abandonment
exceeds one (1) year, full tees shall be paid for a new permit
(4) No work of any manner shall be Gone that will change the natural flow of water causing a drainage problem.
(5) Contractor shall notify the Building Inspector lwenry-four (24) houre in atlvance for all inspections and shall receive writlen approval on inspection card be(ore
proceediing with successive phases of the job.
(6) The issu of a permijjppr the approval of drawings and specifcations shall not be cons[ruetl to he a permit for, nor an approval of, any violation ot the provisions
of the di g/~~~egq~hy other ortlinance, law, rule or re9ulation.
~l~ ~
Chie Building I ector
DEPARTMENT OF PLANNING AND DEVELOPMENT Building Permit Number :
BUILDING INSPECTION LINE - 303-234-5933
CITY OF WHEAT RIDGE Date :
7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80215 - (303-235-2855)
A'PPUc Tla
PropertyOwner:~l~aQy ~~.oRKat~~~- 0K8 4~'N
PropertyAddress: ~7R2d htie-~h-O~e- pk- Phone:3o3-'iz3-233`1
Contractor L;c2nsz No.
Company: 4 ~5l4 Tccl+ r2.06,4rtirl ~ Phone:363._ q Zr/ -0j3`'
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby certify that the setback distances proposed by this pertnit application arz accurater
and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or
covenants, easements or res[rictions 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
aopiication, and that I assume fWl responsibility `or compliance with the Wheat Ridge Building
Code (U.B.C.) and all oiher applicahle e ortlinances, for work under this permit.
/
(OWNER)(CONTRACTOR) SIGN ~ DATE 'S /k a
Construction Value : 3 7
Permit Fee :
Use Tax
Total :
Use
Description
: 11i r- TG-4 e
c-F is
W o o(f'
S14u-v-e-
~I I
A, ,j,PL., ,4 e.u"
yQ~4~
~ Te,w 5 N:
ti.s1 t 5
BUILDING DEPARTMENT USE ONLY
~pg~gg~qg~~ SIC : Sq. Ft. :
Approval :
Zoning :
Approval :
Approval :
Occupancy : Walls : Roof : Stories : Residential Units :
Electrical License No :
Company :
Expiration Date :
Approval :
Plumbing License No :
Company :
Expiration Date :
Approval :
Mechanical License No :
Company :
Expiration Date :
Approval :
(p This permit was issued in accordance with the provisions set forth in ybpur applicaUOn and is sublw to the laws of Ne State of ColoraCO and to the Zonin9
Re9ulations and Builtling Code of Wheat Ritl9e, Colorado or any other applicable artlinances of the Ciry.
(2) TTis permit shall expire if (A) the work auNOnzetl is not commenced within siaKy (fio) Oays from issue Cate or (B) the building authonzeE is suspended or
abantlonetl for a perioC of 120 tlays. '
(3) It this permit expires, a new permit may be acquiretl for a Iee of one-half the amount normally required. provitle0 no changes have Ceen or will Ce matle in the
original plans and specifications and any suspension or abandonment has not exceetleE one (1) year. If changes are maGe or i( suspension or abanCOnment
exceeds one (1) year, full tees shall 6e paid for a new pertnit.
(a) No work of any manner shall be Cone that will change t0e naNral Flow of water causing a Erainage prablem.
(5) Contractor shall notiy the Builtling Inspector twenN-four (24) hours in atlvance for all inspedions and shall receive wntten approval on inspection card before
procee7iing with successive phases of the jo6.
(6) The issuance of a pertnit or Ne appmval of tlrawings and spedfirations shall not be wns[rued to be a permit for, nor an approval of. any violation of the provisions
of the building wtles or any other ordinance, law, rule or regulation.
Chief Building Inspector