HomeMy WebLinkAbout11481 W. 39th PlaceCity of Wheat Ridge
E -Res. Window Replacement PERMIT - 202000219
PERMIT NO: 202000219 ISSUED: 01/31/2020
JOB ADDRESS: 11481 W 39th P1 EXPIRES: 01/30/2021
JOB DESCRIPTION: SWO Replace 15 windows (all on back side of the house: bedrooms, kitchen,
living room, bathroom), u -value =.24
*** CONTACTS ***
OWNER (303)908-1069 BROWNE MICHAEL P
SUB (303)567-4397 CHRISTOPHER JOHNSON 202023 ALPINE CRAFTSMAN, LLC
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 34,610.00
FEES
Window Replacement 50.00
Total Valuation 0.00
Use Tax 726.81
Investigative Fees 50.00
** TOTAL ** 826.81
*** COMMENTS ***
*** CONDITIONS ***
Both the front and back of this permit are required to be posted on the job site at all
times. If the complete permit is not present, inspections WILL NOT be performed.
Work shall comply with 2012 IRC & 2017 NEC. Smoke alarms shall comply with 2012 IRC Section
134. INTERIOR ALTERATIONS, REPAIRS, FUEL -FIRED APPLIANCE REPLACEMENTS, OR ADDITIONS, ANY OF
WHICH REQUIRE A BUILDING PERMIT, OCCURS OR WHERE ONE OR MORE ROOMS LAWFULLY USED FOR
SLEEPING PURPOSES ARE ADDED SHALL HAVE AN OPERATIONAL CARBON MONOXIDE ALARM INSTALLED
WITHIN FIFTEEN FEET OF THE ENTRANCE TO EACH ROOM LAWFULLY USED FOR SLEEPING PURPOSES
. , City of Wheat Ridge
E -Res. Window Replacement PERMIT - 202000219
PERMIT N0: 202000219 ISSUED: 01/31/2020
JOB ADDRESS: 11481 W 39th P1 EXPIRES: 01/30/2021
JOB DESCRIPTION: SWO Replace 15 windows (all on back side of the house: bedrooms, kitchen,
living room, bathroom), u -value =.24
I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specificationst
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 to be performed is disclosed in this document and/or its' accompanying approved plans and specifications.
Signature of OWNER or CONTRACTOR (Circle one) Date
1. 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, po Flans
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 originalpermit 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 changeof the natural flow of water without prior and specific approval.
5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required
inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services
Division.
6. The issuance or gr ing of a perm h 1 not be construed to be a permit for, or an approval of, an violation of any provision of any
applicable code a or inane gulation 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.
CRY of WhatRl�r
|
01/31/2020 15 '
C08022458
AMOUNT
DPSP 11481 W 39th Pi 826.81
oryL/PERMIT NO: 21012O08219
PAYMENT RECEIVED
PP / 2149
81
AUTH CODE; 70518671 826 .81
TOTAL
826.81
��` � ,
Kimberly Cook � `
From: no-reply@ci.wheatridge.co.us
Sent: Wednesday, January 29, 2020 2:20 PM
To: CommDev Permits
Subject: Online Form Submittal: Residential Window/Door Replacement Permit Application
Categories: HOLD, Kim
Residential Window/Door Replacement Permit Application
This application is exclusively for RESIDENTIAL REPLACEMENT WINDOWS and
DOORS - LIKE FOR LIKE ONLY.
YOU MUST ATTACH A VALID CREDIT CARD AUTHORIZATION FORM AND
WINDOW/DOOR CUTSHEET (SPEC SHEET) 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 Yes
replacement window(s)
and/or door(s) like for
like?
PROPERTY INFORMATION
Property Address
Property Owner Name
Property Owner Phone
Number (enter WITH
dashes, eg 303-123-4567)
Property Owner Email
Address
**REQUIRED** Attach
Credit Card Authorization
Form - **DO NOT
ATTACH RANDOM
DOCUMENTS**
11481 W. 39th Place
Mike Browne
303-908-1069
mbbrowne26@gmail.com
CC Authorization. Pd
CONTRACTOR INFORMATION
Contractor Business Alpine Craftsman
Name
Contractor's License 202023
Number (This is a 5 or 6
digit number for the City
of Wheat Ridge)
Contractor Phone 303-514-5414
Number (enter WITH
dashes, eg 303-123-4567)
Contractor Email Address chris.alpinecraftsman@gmail.com
Retype Contractor Email chris.alpinecraftsman@gmail.com
Address
DESCRIPTION OF WORK
Number of window 15
and/or doors being
replaced
Location of all on back side of the house: bedrooms, kitchen, living room,
window(s)/door(s) being bathroom
replaced (for example,
master bedroom, kitchen,
bathroom, etc):
What is the u -value of the .24
window(s)/door(s)? City
of Wheat Ridge requires
the a -value to be .32 or
better on windows..
Attach copy of Jeld-wen window specs.pdf
window/door cut sheets
showing sizes and u -value
Project Value (contract 34,610.02
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
2
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 been Yes
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 Kim Davison
Permit
Email not displaying correctly? View it in yo jr browse,
2
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: Clog_ /202{`
Job Address: 1 % t% / P1,
Permit Number: 2,010010 q
❑ No one available for inspectiottn:-: Time q; ,� , &PM
Re -Inspection required: Yes o
When corrections have been made, ca for re -inspection at 303-234-5933
Date: 5/100 -Inspector: )a, -Ie
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: 3 O to ft-) I -r-)
Job Address: I I LI � ) W 3 c� 41 VL.
Permit Number: cD (-_�) I � Q ) O -jq
❑ No one available for inspection: Time 1 .15 OP
Re -Inspection required: Yes No
When corrections have been made, call for re -inspection at 303-234-5933
Date: 5- 1 / ; Inspector:
DO NOT REMOVE THIS NOTICE
X
City of Wheat Ridge
Residential Roofing PERMIT - 201801034
PERMIT NO: 201801034 ISSUED: 04/12/2018
JOB ADDRESS: 11481 W 39th PL EXPIRES: 04/12/2019
JOB DESCRIPTION: Reroof remove and install Certainteed Presidential Asphalt Shingles with 38
squares. Pitch 5/12.
*** CONTACTS ***
OWNER (303)908-1069 BROWNE MICHAEL P
SUB (303)507-0842 Gumercindo Nunez 090215 GN Roofing, Inc.
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2403 / APPLEWOOD VILLAGES, PROSPECT V BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 28,000.00
FEES
Total Valuation 0.00
Use Tax 588.00
Permit Fee 476.55
** TOTAL ** 1,064.55
*** 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.
City of Wheat Ridge
Residential Roofing PERMIT - 201801034
PERMIT NO: 201801034 ISSUED: 04/12/2018
JOB ADDRESS: 11481 W 39th PL EXPIRES: 04/12/2019
JOB DESCRIPTION: Reroof remove and install Certainteed Presidential Asphalt Shingles with 38
squares. Pitch 5/12.
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
thisermit. I further attest that I am legally authorized to include all entities named within this document as parties to the work to be
performed and that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications.
Signature of OWNER or CONTRACTOR (Circle one) Date
I , This permit was issued based on the information provided in 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 originalpermit 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 an manner shall be performed that shall results in a changeof the natural flow of water without prior and specific approval.
5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required
inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services
Division.
6. The issuance or grantin of a permit shall not be construed to be a permit for, or an approval of, an violation of any provision of any
applic code or any jrcjinance 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.
Lagenia Reimer
1/1
e) U %M
From: no-reply@ci.wheatridge.co.us
Sent: Thursday, April 12, 2018 1:46 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.
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
11481 W, 39TH PL
MIKE BROWN
303-908-1069
mbbrowne26@aol.com I
/0�
5 n
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 contract.pdf
Contract
CONTRACTOR INFORMATION
Contractor Business GN Roofing,inc
Name
Contractor's License 090215
Number (This is a 5 or 6
digit number for the City
of Wheat Ridge)
Contractor Phone 303-507-0842
Number (enter WITH
dashes, eg 303-123-4567)
Contractor Address 6403 e, laguna cir highlands ranch, CO 80130
(Primary address of your
business)
Contractor Email Address
gnroofing@aol.com
Retype Contractor Email
gnroofing@aol.com
Address
DESCRIPTION OF WORK
TOTAL SQUARES of
38 sq tear off existing asphalt shingles and install back certain
the entire scope of work:
teed tl presidential shingles
Project Value (contract
28,000
value or cost of ALL
materials and labor)
Are you re -decking the No
roof?
Is the permit for a flat Pitched roof (2:12 pitch or greater)
roof, pitched roof, or
both? (check all that
apply)
2
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 any additional
detail here on the
description of work. (Is
this for a house or
garage? Etc)
5/12
38 sq
certain teed tl presidential shingles install back
Asphalt
ROOF REPLACEMENT
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 Gumer Nunez
Email not displaying correctly? View it in your browser.
GN ROOFING, INC.
6403 Laguna Circle
Highlands Ranch, C 7 �/ i � 80130 CONTRACTOR
P. 303,507.0842 F. 720.282-5786
gnroofing@aol.com
www,gn-roofing.com 11"MI E T
THIS AGREEMENT made the 22 day of march 2018, by and between Gumercindo Nunez
Contractor: GN Roofing, Inc. homeowner: Mike Brown.
WITNESSETH that the Contractor and the Owner for the considerations named agree as follows:
Scope of Work
The Contractor shall furnish all materials and perform all of the work on the property at 11481 w, 391h place wheat
ridge, Colorado 80033
Work Performed
TEAR OF EXISTING 46 SQ, OF ASPHALT SHINGLES ROOF, INSTALL TAMKO ICE AND WATER SHIELD ON BOTTOM EDGE
AND VALLEYS, INSTALL FELTEX ON THE REST THE ROOF, NEW DRIP -EDGE AND RAKE FLASHING, INSTALL NEW
CERTAINTEED PRESIDENTIAL TL ASPHALT SHINGLES COLOR AUTUMN BLEND, REPLACE SMALL FLAT ROOF WITH
SIMILAR MATERIAL. TEAR OF EXISTING 5" GUTTERS AND INSTALL NEW 5" GUTTERS AND 2X3 DOWNSPOUT.
LABOR WARRANTY IS TWO YEARS.
Contract Price
The Owner shall pay the contractor for material and labor to be performed under the sum of $28,000.00
Payment Schedule
The first payment (50%) THE FIRST PAYMENT IS WHEN WE START THE JOB, THE LAST PAYMENT WHEN WE
FINISHED.
Terms and Conditions
1. Due to the application of heavy roofing products, settling cracks on walls or ceilings are not the
responsibility of GN Roofing, Inc.
2. Labor warranty does NOT cover damage to roofs caused by violent storms, foreign objects or settlement of
foundation walls.
3. Warranty begins upon completion and payment in full.
4. These terms and conditions can be changed at any given time.
5. All money orders and checks are to be made to GN Roofing, Inc.
Agreement
I, , /I `^�, _ , have read the above statements and agree to abide by them.
Signed i% >
ContractorG�
Date 12..1 e/ S.
Date 03/22/2018
INSPECTION RECORD bccupancvlTVpe
INSPECTION LINE: (303)234 -5933
Inspections will not be made unless ' this card is posted on the building site
Call by 3:00 PM to receive inspection the following business day.
INSPECTOR MUST SIGN ALL SPACES PERTAINING TO THIS J OB
FOUNDATION INSPECTIO
al
COMMENTS:
Footings /Caissons
ical
Stemwall / (CEG) ConcreEncased Ground
: Z?
tLand scapin g
Reinforcing or M onolithic
Final _
Weatherproof / French Dr-
Drainage
Sewer Service Lines
ANNING $ ZONING, FIRE AND PUBLICE WORKS
AT LEAST ONE WEEK PRIOR TO FINAL INSPECTIONS.
&Landscaping
- -
Water Service Lines
-
CONCRETE SLAB FLOOR
Ele ctrical (Underground)
Plumbing(Underground)
Heating (Underground)
ROUGHS
POUR NO CONCRETE U NTIL ABOVE HAS BEEN SIGNED
- - -`--
DO NOT POUR FLOOR UNTIL ABOVE }LAS BEEN SIGNED
,Lath / Wall tie _
Mid Roof: ` -
,;� Electrical Service
Rough Electric
Rough Plumbing
Gas Piping
Rough Mechanical -
'ABOVE INSPECTIONS TO BE SIGNED PRIOR TO PROCEEDING
Framing
Insulatiori ".
Drywall Screw
JCCUPANCY NOT PERMITTED UNTIL OERTIFICATE OF OCCUPANCY IS ISSUED
PROTECT THIS CAP? FROM THE WEATHER
al
g
ical
: Z?
tLand scapin g
PINSPECTIONS
Final _
partme nt
Drainage
ANNING $ ZONING, FIRE AND PUBLICE WORKS
AT LEAST ONE WEEK PRIOR TO FINAL INSPECTIONS.
&Landscaping
"NOTE: ALL ITEMS MUS BE COMPLETED AND APPROVED BY PLANNING AND ZONING, BUILDING AND PUBLIC WORKS BEFORE A
CERTIFICATE OF OCCUPANCY IS ISSUED. FINAL INSPECTION BY THE BUILDING'DIVI DOES NOT CONSTITUTE AUTHORIZATION
OF A- CERTIFICATE OF OCCUPAI CY -,NOR PERMISSION FOR OCCUPANCY. —
JCCUPANCY NOT PERMITTED UNTIL OERTIFICATE OF OCCUPANCY IS ISSUED
PROTECT THIS CAP? FROM THE WEATHER
A ✓ CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234 -5933 Inspection line
(303) 235 -2855 Office • (303) 237 -8929 Far
INSPECTION NOTICE
Inspection Type: F
Job Address: 11Y5V AV
Permit Number: _ A90 3w
Ll �
❑ No one available for inspection: Time AM E
Re- inspection required: Yes No
When corrections have been made, call lf for rr re-inspection at 303- 234 - 5933
Date: S/ //0 Inspector
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: ,w/=
Job Address: y8/ w YTI-W Al -
Permit Number: ssz~ X32
- kAlr,-41' .
❑ No one available for inspection: Time Sd AM/
Re-Inspection required: es No
When corrections have been made, call for re-inspection at 303-234-5933
Date: Inspector:
DO NOT REMOVE THIS NOTICE
f
♦ , f CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: rwll_) R go F
Job Address: //Vg,/ w ?9,w dZ,
Permit Number: svc232
❑ No one available for inspection: Time o AMJP~
Re-Inspection required: Yes A5)
When corrections have been made, ~ca--ff~for re-inspection at 303-234-5933
k
G~= Date: 4/,47/,a Inspector:
r
DO NOT REMOVE THIS NOTICE
u
~i
> "4' City of Wheat Ridge
roooor Residential Roofing PERMIT - 100232
PARCEL INFO
ZONE CODE: UA ' =USE: UA
-SUBDIVISION: r 0193 BLOCK/LOT#: 0/
FEE SUMMARY ESTIMATED PROJECT VALUATION: 16,500.00
FEES
i& mid-roof inspection ri
ich apart requires plywooc
-ed from eave edge to 2'
City of Wheat Ridge Building Division Date:
7500 W. 29th Ave., Wheat Ridge, CO 80033
Office: 303-235-2855 * Fax: 303-237-8929 Plan
~o--- o Inspection Line: 303-234-5933
rorxi+o Permit (U O r ~g ,
Building Permit Application
Piop'ert Address: lLA jam( j,:sCr ` , _ p z,
PropertyOwner(pleaseprint)- ~/~jl (fie ~ Phone:3&~- n--/0(;L7
Mailing Address: (if different than property address)
Address:
City, State, Zip:
Contractor: r
Contractor License 021 s Phone:
Sub Contractors:
Electrical City License Plumbing City License Mechanical City License
Company: Company Company:
Exp. Date: Exp. Date: Exp. Date:
Approval:
Approval: Approval:
Use of space (description): ~2 RAJ /J Construction Value: $
Description of work- (as calculated per the Building Valuation Data sheet)
Plan Review (due at time of submittal): $
Sq. Ft./L. Ft added: Squares BTU's Gallons Amps
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby certify that the setback distances proposed by this permit application are accurate, and do not violate applicable ordinances,
Eresponsibbility lations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown, and
ade are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full
for compliance with the Wheat Ridge Building Code (I.B.C) and all other applicable Wheat Ridge Ordinances, for work
rmit. Plans subject to field inspection.
E:: ((OOWNER) (CONTRACTOR) or PERSONAL REPRESENTATIVE of (OWNE R) (CONTRATOR)
E: Gwt~.-Cla~dv ~ SIGNATURE:~_~j~ c2J )/j~Y, Dater
QEPA`RTAi(ENT l1SE ON LY
ZONiNG.GOMME,NTS ~
- _
Zomng:'
Reviewer,
PUBLtC WORKS COMMENTS
;Reviewer
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SUILDIN6 DE15ARThYENT COMMENTS
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Valuation:$
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