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t= PERMIT NO:
10
10
pF WHEgT,Q City of Wheat Ridge Building Division
7500 W. 29 Ave., Wheat Ridge, CO 80033
Office: 303 - 235 -2855 * Fax: 303 - 235 -2857
c o Inspection Line: 303 - 234 -5933
O CORPp
Date: C'l
Plan #: C Q J CCY %' 7
Permit #: I C, I
1
Property Address: 20 f •'n�r7
Property Owner (please print): 4 f-,00,/ t �Jkee "heJq( Phone: Ree
Mailing Address: (if different than property address)
Address:
City, State, Zip:
Building Permit Application
Contractor: A 111C if, L ✓1 y J 66 l i rLX-4 or �
Contractor License #: Phone: 3 oT - 79 S - -h 8 7'
Sub Contractors:
Electrical City License #:
Company:
Plumbing City License #:
Company
Mechanical City License #:
Company:
Exp. Date:
Exp. Date:
Exp. Date:
Use of space (description): Construction Value: $
Description work: work: ,} (as calcu l izr the Building Valuation Data sheet)
TV,V4w,t,(w'Ir}��tt= `�ntt Wkaw% ^�e...t rpt5t, P lan Review(due at time of s6lvrii aQ-$
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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,
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 the Wheat Ridge Building Code (I.B.C) and all other applicable Wheat Ridge Ordinances, for work
under this permit. Plans subject to field inspection.
CIRLCE ONE:: (OWNER) (CONTRACTOR) or PERSONAL REPRESENTATIVE of (OWNER) ( CONTRATOR)
PRINT NAME: SIGNATURE: Date:
DEPARTMENT'USE ONLY
ZONING COMMENTS Crl
Zoning
Reviewer„
PUBLIC WORKS COMMENTS:
Reviewer: 7
BUILDING DEPARTMENT C - )V MENTS
. 7'T fGU:�! P ✓� ��/`.I✓✓ rlL� 5 _ OCCUPANCY., v
Reviewer V �V - 5,L 1 6 'e — (D f / I� �
FIRE DEPARTMENT:: 11 " proved w/ comments ❑ disapproved 173 no review required.. Bldg Valuation: $