The URL can be used to link to this page

Home My WebLink About3585 Fenton StreetZol-7D6gbf °ccupancv/Type INSPECTION RECORD a .�S`fi o F-��-oma S�-; ?6' INSPECTION ONLINE FORM: http://www.ci.wheatridge.co.us/inspection INSPECTION REQUEST LINE: (303) 234-5933 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 11:59 p.m. (midnight) to receive an inspection the following business day.** Inspector Must Sign ALL Spaces pertinent to this project Foundation Inspections Date Inspector Initials Comments Pier Concrete Encased Ground (CEG) Foundation / P.E. Letter Lath / Wall Tie Do Not Pour Concrete Prior To Approval Of The Above Inspections Underground/Slab Inspections Date Inspector Comments Initials Electrical Sewer Service Plumbing Do Not Cover Under round or Below/In-Slab Work Prior To Approval Of The Above Inspections Rough Inspections Date Inspector Initials Comments Wall Sheathing Mid -Roof Lath / Wall Tie Rough Electric Rough Plumbing/Gas Line Rough Mechanical Rough Framing Rough Grading Insulation Drywall Screw / Nail Final Inspections Date Inspector Initials Comments Landscaping & Parking / Planning Dept. Inspections from these entities should be requested one week in advance. For landscaping and parking inspections call 303-235-2846. For ROW and drainage inspections call 303-235-2861. For fire inspections contact the Fire Protection District for your project. ROW & Drainage / Public Works Dept. Floodplain Inspection (if applicable) Fire Inspection / Fire Protection Dist. Final Electrical Final Plumbing Final Mechanical Roof Final Window/Doors Final Building NOTE: All items must be completed and approved by Planning, Public Works, Fire and Building before a Certificate of Occupancy is issued. Approval of the Final Building inspection does not constitute authorization of occupancy. For low voltage permits — Please be sure that rough inspections are completed from the Fire District and electrical low voltage by the Building Division. Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued Protect This Card From The Weather City of Wheat Ridge Residential Roofing PERMIT - 201706461 PERMIT NO: 201706461 ISSUED: 08/23/2017 JOB ADDRESS: 3585 Fenton ST EXPIRES: 08/23/2018 JOB DESCRIPTION: Residential Re -roof to install asphalt shingles - 17 sq *** CONTACTS *** OWNER (303)424-6258 MAGEE MARJORIE SUB (303)216-0712 Marty Cone 018353 Cone Roofing Services *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2412 / LAKESIDE, STEWART GARDENS, OLI BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 4,369.00 FEES Total Valuation 0.00 Use Tax 91.75 Permit Fee 125.05 ** TOTAL ** 216.80 ----_ *** 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) 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. Roof inspections for ROOFS OVER 6/12 PITCH: 3rd party inspection will be required, the 3rd party inspection report will be collected at final roof inspection performed by City of Wheat Ridge. If report is not available the final inspection will not be completed. City of Wheat Ridge Residential Roofing PERMIT - 201706461 PERMIT NO: 201706461 ISSUED: JOB ADDRESS: 3585 Fenton ST EXPIRES: JOB DESCRIPTION: Residential Re -roof to install asphalt shingles 08/23/2017 08/23/2018 17 sq I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this ermrt. I further attest that I m le ally authorized to include all entities named within this document as parties to the work to be performed and that all worldrmed is disclosed in this document and/or its' accompanying approved plans and specifications. Signature of bWNER or C'bNTRA R (Circle one) Date I. This permit was issued based on the informa ' n provided in the permit application and accompanyingptans 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. 1 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. Theissuance ting 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 y ordinanula 'op 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. Antoinette Kulick IN% l �( From: no-reply@c i.wheatridge.co.us Sent: Monday, August 21, 2017 6:51 PM To: CommDev Permits Subject: Online Form Submittal: Residential Roofing Permit Application Follow Up Flag: Follow up Flag Status: Completed 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? 74S tAffw t� JgIJ7 How many dwelling units Single Family Home are on the property? PROPERTY INFORMATION 11 Property Address 3585 fenton st Property Owner Name Magee Property Owner Phone 303 424 6258 Number (enter WITH dashes, eg 303-123-4567) 17 $ Property Owner Email Field not completed. Address 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 image.ipg Contract CONTRACTOR INFORMATION Contractor Business Cone roofing services Name Contractor's License 018353 Number (This is a 5 or 6 digit number for the City of Wheat Ridge) Contractor Phone Number (enter WITH dashes, eg 303-123-4567) Contractor Address (Primary address of your business) 303-961-2063 15263 w 51 st place golden co 80403 Contractor Email Address bmconehead@yahoo.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? bmconehead@yahoo.com 17 -4666— $ 6 No 18 Does the scope of the No project include a flat roof (less than 2:12 pitch)? Does the scope of the Yes project include a pitched roof (2:12 or greater pitch)? How many squares are 17 part of the pitched roof? Describe the roofing 30 yr dimensional materials for the pitched roof: Type of material for the Asphalt pitched roof: Provide any additional House. 4:12. 1 layer detail here on the description of work. (Is this for a house or garage? What is the roof pitch? Etc) 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. 19 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. Name of Applicant Marty Cone Email not displaying correctly? View it in your browser. 20 '<�::> CONE <:>< Roofing & Painting, LLC Gutters • Sky(ights • Home Improvements PROPOSAL FROM: CONE ROOFING & PAINTING, LLC 15263 WEST 51 ST PLACE GOLDEN, COLORADO 80403 303-216-0712 303-961-2063 PROPOSAL SUBMITTED TO: YY l aG -e e 36-s5- FV-r,4n DATE: G171)1? PROPOSAL # 13 M " I RE: We hereby propose to furnish and perform all the labor necessary for the completion of roofing & painting Remove Layer(s) Haul away all debris. Prep roof surface. Install ice & water sheild with metal drip edge. Install tar paper over entire surface. Upgrade all flashing and metals where necessary. Install new 30 year designer laminate shingles. Six nails per shingle. Protect, clean all grounds. City Permit. Color of Choice. k4n, &L-11jt,4qJ L-t�r CA-� % A-1 All materials are guaranteed to be as specified, and the above work to be performed in accordance with the drawings and specifications submitted for the above work and completed in a substantial workmanlike manner. FOR THE SUM OF: SEE ABOVE - 7ono.� Payments made as follows: 50% UPON ACCEPTANCE, 50% UPON COMPLETION / *Any invoice not paid on due date will incur interest at the rate of 2% per month or 24% per annum. *If lit' gation results to secure payment, legal fees will be due to prevailing parties. A Iterations or deviation from above specifications involving extra costs, will be executed only upon written orders, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado and other necessary insurance upon above work. Workmen's compensation and Public Liability Insurance on above work to be taken by CONE ROOFING & PAINTING. LLC, Ir R Respectfully submitted City of Wheat Ridge Residential Roofing PERMIT - 201706461 PERMIT NO: 201706461 ISSUED: 08/23/2017 JOB ADDRESS: 3585 Fenton ST EXPIRES: 08/23/2018 JOB DESCRIPTION: Residential Re -roof to install asphalt shingles - 17 sq *** CONTACTS *** OWNER (303)424-6258 MAGEE MARJORIE SUB (303)216-0712 Marty Cone 018353 Cone Roofing Services *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2412 / LAKESIDE, STEWART GARDENS, OLI BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 4,369.00 FEES Total Valuation 0.00 Use Tax 91.75 Permit Fee 125.05 ** TOTAL ** 216.80 ----_ *** 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) 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. Roof inspections for ROOFS OVER 6/12 PITCH: 3rd party inspection will be required, the 3rd party inspection report will be collected at final roof inspection performed by City of Wheat Ridge. If report is not available the final inspection will not be completed. City of Wheat Ridge Residential Roofing PERMIT - 201706461 PERMIT NO: 201706461 ISSUED: JOB ADDRESS: 3585 Fenton ST EXPIRES: JOB DESCRIPTION: Residential Re -roof to install asphalt shingles 08/23/2017 08/23/2018 17 sq I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this ermrt. I further attest that I m le ally authorized to include all entities named within this document as parties to the work to be performed and that all worldrmed is disclosed in this document and/or its' accompanying approved plans and specifications. Signature of bWNER or C'bNTRA R (Circle one) Date I. This permit was issued based on the informa ' n provided in the permit application and accompanyingptans 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. 1 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. Theissuance ting 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 y ordinanula 'op 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. Antoinette Kulick IN% l �( From: no-reply@c i.wheatridge.co.us Sent: Monday, August 21, 2017 6:51 PM To: CommDev Permits Subject: Online Form Submittal: Residential Roofing Permit Application Follow Up Flag: Follow up Flag Status: Completed 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? 74S tAffw t� JgIJ7 How many dwelling units Single Family Home are on the property? PROPERTY INFORMATION 11 Property Address 3585 fenton st Property Owner Name Magee Property Owner Phone 303 424 6258 Number (enter WITH dashes, eg 303-123-4567) 17 $ Property Owner Email Field not completed. Address 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 image.ipg Contract CONTRACTOR INFORMATION Contractor Business Cone roofing services Name Contractor's License 018353 Number (This is a 5 or 6 digit number for the City of Wheat Ridge) Contractor Phone Number (enter WITH dashes, eg 303-123-4567) Contractor Address (Primary address of your business) 303-961-2063 15263 w 51 st place golden co 80403 Contractor Email Address bmconehead@yahoo.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? bmconehead@yahoo.com 17 -4666— $ 6 No 18 Does the scope of the No project include a flat roof (less than 2:12 pitch)? Does the scope of the Yes project include a pitched roof (2:12 or greater pitch)? How many squares are 17 part of the pitched roof? Describe the roofing 30 yr dimensional materials for the pitched roof: Type of material for the Asphalt pitched roof: Provide any additional House. 4:12. 1 layer detail here on the description of work. (Is this for a house or garage? What is the roof pitch? Etc) 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. 19 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. Name of Applicant Marty Cone Email not displaying correctly? View it in your browser. 20 '<�::> CONE <:>< Roofing & Painting, LLC Gutters • Sky(ights • Home Improvements PROPOSAL FROM: CONE ROOFING & PAINTING, LLC 15263 WEST 51 ST PLACE GOLDEN, COLORADO 80403 303-216-0712 303-961-2063 PROPOSAL SUBMITTED TO: YY l aG -e e 36-s5- FV-r,4n DATE: G171)1? PROPOSAL # 13 M " I RE: We hereby propose to furnish and perform all the labor necessary for the completion of roofing & painting Remove Layer(s) Haul away all debris. Prep roof surface. Install ice & water sheild with metal drip edge. Install tar paper over entire surface. Upgrade all flashing and metals where necessary. Install new 30 year designer laminate shingles. Six nails per shingle. Protect, clean all grounds. City Permit. Color of Choice. k4n, &L-11jt,4qJ L-t�r CA-� % A-1 All materials are guaranteed to be as specified, and the above work to be performed in accordance with the drawings and specifications submitted for the above work and completed in a substantial workmanlike manner. FOR THE SUM OF: SEE ABOVE - 7ono.� Payments made as follows: 50% UPON ACCEPTANCE, 50% UPON COMPLETION / *Any invoice not paid on due date will incur interest at the rate of 2% per month or 24% per annum. *If lit' gation results to secure payment, legal fees will be due to prevailing parties. A Iterations or deviation from above specifications involving extra costs, will be executed only upon written orders, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado and other necessary insurance upon above work. Workmen's compensation and Public Liability Insurance on above work to be taken by CONE ROOFING & PAINTING. LLC, Ir R Respectfully submitted i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Job Address: PermitNumber: ❑ No one available for inspection: Time M/,PM Re -Inspection required: Yes When corrections have been made Vcore-ins ection at 303-234-5933 Date: �' 1— Inspector: DO NOT REMOVE THIS NOTICE 30IION SIHI 3AOW3hf ION 00 le uoi;aadsui-aa ao{ ileo `apew uaaq Sney s oijDaJJOO uayM„ spA :paainbai uoiloodsul-aH viIdLWb' _,: ,.: s quail :uoijoadsui aol agepAe quo ON C i ` 1 /✓ :aagwnN 1iwa8d :ssaippd qof :adA1 uoijoadsul l� 33IION N01133dSNI xe-4 6E68-LOE (COO) • eDi-4o .938E -38E (SOs) aury uolloadsul ££69-b£Z (£0£) uoisinia uoijoadsul fuipjin8 3Jaiu 1V3HM =10 A113 A y Ilk, 10/12/2012 FRI 9:24 FAX 3033430032 Done Service - Aurora Im City of Building Permit Application (Complete 0 highlighted areas) P Plan gg Kermit # 1, *0 (please print): (Y) Ck r Ci e TY e Phone: 0 IM (if different then property addressl Address: City, State, Zip. License ElectricI City License # N N= City License # Mechanical: City License # C )lvd I L Squares _ BTU's _ Gallons __ Amps- _—, Sq Ft Review Fee (Oua at fim of submill ♦ i CITY OF WHEAT RIDGE Building Inspection Division (303) 234 -5933 inspection line _ (303) 235 -2855 Office • (303) 237 -8929 Fax INSPECTION NOTICE Inspection Type: Job Address: L e1A �K Permit Number: to(.� A Kd'r'r o4 ❑ No one available for inspection: Time ,() AfvY /) Re- Inspection required: Yes No When corrections have been made, call or re- ins l{ecti n at 303 -234 -5933 I{ /j1 Date: ` 7'(PI Inspector: �d4�a DO NOT REMOVE THIS NOTICE ♦ I i CITY OF WHEAT RIDGE Building Inspection Division (303) 234 -5933 Inspection Mine (303) 235 -2855 Office • (303) 237 -8929 Fax INSPECTION NOTICE Inspection Type:L Job Address: cr Permit Number: t ° .❑ No one available for inspection: Time f i PY PM Re- Inspection required: Ye ) No "When corrections have been made, call for re- inspection at 303 - 234 -5933 Date: r'lU Inspector: r� DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE' /V, Building Inspection Division (303) 234 -5933 Inspection line (303) 235 -2855 Office • (303) 237 -8929 Fax INSPECTION NOTICE Inspection Type: Sf�Srt779ir// Job Address: 3S S / 57" Permit Number: ❑ No one available for inspection: Time 1 , AS AMAE Re- Inspection required: Yes No "When corrections have been made, can for re inspection at 303 -234 - 5933 Date: t;�I Inspector: DO NOT REMOVE THIS NOTICE Citv of Wheat Ridge Vt 101586 SUED 06/22/. :PIRES: 12/19/. :k Cit of 77_� y L feat C Date: bbb -^�OMMUNITY DEVELOPMENT - Plan # Building & Inspection Services Division Permit # 7500 W. 29" Ave., Wheat Ridge, CO 80033 Office: 303 - 235 - 2855 " Fax: 303 - 237 -8929 Inspection Line: 303 - 234 -5933 Building Permit Application Property Andress; ^t� Property Owner (please print): Phone: Mailing Address: (if different than property address) Address: City, State, Zip: Con�iraator: �� .e.rvfc� Contractors City License #; Phone: 3 Sub Co ntractorsz Electrical: Plumbing: Mechanical: City License # City License # City License # �17escri o� work's (/Girt �aE�a / $otra Review Fee (due at time of submittal): Squares 2- -' BTU's Gallons Amps Sq Ft. $ 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 records 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. CIRCLEONE: (OWNER) (CONTR R ar (AUTHORIZED RE PRESENTATIVE) ) SENTATIVE) .(OWNER). (CONTRACTOR) PRINT PRINT NAME: SIGNATURE: J / 1 ^' DATE: Z GO ng v r a f, J„t .j ,/ /L. r �..-; , bii' / z / ! ;y//T„�1�,.. i r✓ /� � ��'�B lY-Sa /" / �' � � ✓ N.^,/ / ,y/ ti � �.. mr /�� 02 "' �' � �, �} r r h / ReVlevfer / •,9 f /� f rr� C n n / ,,,, 4 ,� r lr � r. .: /° ".. �,. / ��/ t / ��r ✓�f /,i '' t �iu �. zy� �" / ai � t / b � �'` � a'ro' 3�J�� i z 5. / M �,, v ✓'„ y f'i" a �.,� � i > ' � � l 3 L„ r' i 4i '/ "/'y / Ls /' Y / ,. � a ,?s 'mss y/✓ � / � r a°"``' Bldg Valuation:$