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Home My WebLink About3004 Kendall StreetINSPECTION RECORD Inspection online form: http://www.ci.wheatridge.co.us/inspection Cancellations must be submitted via the online form before 8 a.m. the day of the inspection Inspections will not be performed unless this card is posted on the project site Request an inspection before MIDNIGHT (11:59 PM) to receive an inspection the following business day PERMIT: W6 Del ADDRESS:JOB CODE: Foundation Inspections Date Inspector Initials Comments 102 Caissons / Piers 103 Footing / P.E. Letter 104 Foundation Setback Cert. 105 Stem Walls 106 Foundation wall Insulation i Do Not Pour Concrete Prior To Approval Of The Above Inspections Underground / Slab Inspections Date Inspector Initials Comments 201 Electrical / Cable/ Conduit 202 Sewer Underground Int. 203 Sewer Underground Ext. 204 Plumbing Underground Int. 205 Plumbing Underground Ext. i 206 Water Underground Do Not Cover Underground or Below / In -Slab Work Prior To Approval Of The Above Inspections Rough Inspection Date Inspector Initials Comments 301 Rough Framing 302 Wall Sheathing 303 Roof Sheathing 304 Sheer Inspection i=' insulation i 306 Mid -Roof 307 Metal / Lath / Stucco 308 Rough Electrical Residential 309 Rough Electrical Commercial 310 Electrical Meter Residential 311 Electrical Meter Commercial 312 Temp. Const. Meter 313 Rough Plumbing Residential 314 Rough Plumbing Commercial 315 Shower Pan SEE OVER FOR ADDITIONAL INSPECTIONS PERMIT: 1'j ADDRESS: JOB CODE: Rough Inspection (continued) Date Inspector Initials Comments 316 Rough Mechanical Residential 402 Gas Meter Release 317 Rough Mechanical Commercial 403 Final Electrical Residential 318 Boiler / Furnace 404 Final Electrical Commercial 319 Hot water tank 405 Final Mechanical Residential 320 Drywall screw and Nail 406 Final Mechanical Commercial 321 Moisture board / shower walls 407 Final Plumbing Residential 322 Rough Grading 408 Final Plumbing Commercial 323 Miscellaneous 409 Final Roof Finallnspections 1 Date Inspector in1b.als Comments 401 Gasline 402 Gas Meter Release 403 Final Electrical Residential 404 Final Electrical Commercial 405 Final Mechanical Residential 406 Final Mechanical Commercial 407 Final Plumbing Residential 408 Final Plumbing Commercial 409 Final Roof 410 Final Window/Door 411 Land scape/Park/Planning* Inspections from these entities shall be requested one week in advance. '`For landscaping and parking inspections please call 303-235-2846 "For ROW and drainage inspections please call 303-235-2861 r. r".c ..^.5 r.�4il Glla ,^.i2::2`F4 (:tll l:i�:? .. <: . c Protection District for your project. 412 Row/Drainage/Public Works"* 413 Flood plain Inspection'`* 414 Fire Insp. / Fire Protection*** 415 Public Works Final** 14 io' _iorro -P` a --r ivig lli. 417 Zoning Final Inspection* 418 Building Final Inspection 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 by the Fire District and Electrical low voltage by the Building Division. i CITY OF WHEAT RIDGE `w Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: L/ o _<7— Job Job Address: o i-/ k d' l 1 �-�- Permit Number: 0 1 g 0 a 9 R e c ❑ No one available for inspection: Time = c/O AMAM Re -Inspection required: Yes When corrections have been made, call for re -inspection at 303-234-5933 Date:-(-/,// -_z, / R Inspector: `F- p DO NOT REMOVE THIS NOTICE City of Wheat Ridge r Residential Plumbing PERMIT -201800984 PERMIT NO: 201800984 ISSUED: 04/09/2018 JOB ADDRESS: 3004 Kendall ST EXPIRES: 04/09/2019 JOB DESCRIPTION: Replace furnace with 800 60k. *** CONTACTS *** OWNER (303)237-5996 LILLO LAWRENCE SUB Andy Swan 150271 Swan Heating & Air Denver *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 5,500.00 FEES Furnace Replacement 40.00 Total Valuation 0.00 Use Tax 115.50 ** TOTAL ** 155.50 *** COMMENTS *** *** CONDITIONS *** All work shall comply 2012 International Codes, 2014 NEC (if applicable), and ordinances adopted by the City of Wheat Ridge. Work is subject to field inspections. I, by in 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 theproperty and am authorized to obtain this permit and perform the work described and approved in conjunction with this pen -nit. 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 perfo is disclosed in this document and/or %its' acc mpanying approved plans and specifications. Signature of OWNER or CONTRACTOR (Circle one) Date / I 1. This permit was issued based on the information provided in thepermit 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 maybe subject to a fee equal to one-half of the originalpermlt fee. 3. If this permit expires, anew 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 grant 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 dinance or regulation of this jurisdiction. Approval of work is subject to f eld inspection. Signature of Chilf Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. City ofy_ e t ` Ie r� COMML]NtTy I)EVEwpmEN"[' V E D Building & Inspection Services Division APR 0 9 2018 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/Per 't # Plan Review Fee: Building Permit Application *** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: '�)C cs lz_)_� ( LILo�" ick Co, 3c'i) 4 Property Owner (please print): F-lover1C"t (-1 uC7 Phone: _�>O-3 -p3-j_ 5q7(p Property Owner Email: I l ! j U 0 cnmC-o C4, kO Mailing Address: (if different than property address) Address: City, State, Zip: Arch itect/Engoneer• Architect/Engineer E-mail: Phone: Contractor: --) ice 4� -�_a- , " q— `N � (?, r� VC C Contractors City License #: 1 50.� i Phone: _:"303- U 8'S. -/ 0-77 Contractor E-mail Address: For Plan Review Questions & Comments (please print): `� CONTACT NAME (please print): t f 6t L I SJ C1 & y s o'7 Phone: 3 o 3-- b'9A- %D 9 % ❑ COMMERCIAL LTJ RESIDENTIAL Description of work: (Check all that apply) ❑ NEW COMMERCIAL STRUCTURE ❑ ELECTRICAL SERVICE UPGRADE ❑ NEW RESIDENTIAL STRUCTURE ❑ COMMERCIAL ROOFING ❑ COMMERCIAL ADDITION ❑ RESIDENTIAL ROOFING ❑ RESDENTIAL ADDITION ❑ WINDOW REPLACEMENT ❑ COMMERCIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.) ❑ RESIDENTIAL ACCESSORY STRUCTURE (Garage, shed, deck, etc.) JeMECHANICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT ❑ PLUMBING SYSTEM/APPLIANCE REPAIR or REPLACMENT ❑ ELECTRICAL SYSTEM/APPLIANCE REPAIR or REPLACEMENT ❑ OTHER (Describe) (For ALL projects, please 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 and amount of materials to be used, etc.) Sq. FULF Btu's Gallons Amps Squares Other Project Value: (Contract value or the cost of all materials and labor included in the entire project) OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT 1 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 on the application. CIRCLE ONE: (OWNER) (CONTRACTOR) or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) Signature (first and last name)��1 DATE: ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: DEPARTMENT USE ONLY OCCUPANCY CLASSIFICATION: Building Division Valuation: $ a -O 0 0 3 60 � "3� 4 1et,�- INSPECTION RECORD INSPECTION ONLINE FORM: http://www.ci.wheatridge.co.us/inspection INSPECTION REQUEST LINE: (303) 234-5933 Occupancy/Type /�e 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 Comments Initials Pier Wall Sheathing Concrete Encased Ground (CEG) Sewer Service Foundation / P.E. Letter Mid -Roof Do Not Pour Concrete Prior To Approval Of The Above Inspections Underground/Slab Inspections Date Inspector Comments Initials Electrical Wall Sheathing Sewer Service Mid -Roof Plumbing Do Not Cover Underground 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 {Y PERMIT NO: JOB ADDRESS: JOB DESCRIPTION City of Wheat Ridge Residential Roofing PERMIT - 201703009 201703009 ISSUED: 07/01/2017 3004 Kendall ST EXPIRES: 07/01/2018 Residential Re -roof to install Tamko Heritage asphalt shingles with 31 sq. *** CONTACTS *** OWNER (303)237-5996 LILLO LAWRENCE & FLORENCE SUB (303)457-2060 Phillip Gamble 090236 Rembrandt Enterprises *** PARCEL INFO *** ZONE CODE: SUBDIVISION CODE: *** FEE SUMMARY *** Total Valuation Use Tax Permit Fee ** TOTAL ** *** COMMENTS *** UA / Unassigned USE: UA / Unassigned 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / ESAIMATED PROJECT VALUATION FEES 0.00 311.58 283.55 595.13 14,837.00 *** 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 one half 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 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 - 201703009 PERMIT NO: 201703009 ISSUED: 07/01/2017 JOB ADDRESS: 3004 Kendall ST EXPIRES: 07/01/2018 JOB DESCRIPTION: Residential Re -roof to install Tamko Heritage asphalt shingles with 31 sq. *** CONTACTS *** OWNER (303)237-5996 LILLO LAWRENCE & FLORENCE SUB (303)457-2060 Phillip Gamble 090236 Rembrandt Enterprises *** PARCEL INFO *** ZONE CODE: UA / Unassigned USE: UA / Unassigned SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 14,837.00 FEES Total Valuation 0.00., Use Tax 311.58 Permit Fee 283.55 ** TOTAL ** 595.13 *** 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 one half 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 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 - 201703009 PERMIT NO: 201703009 ISSUED: 07/01/2017 JOB ADDRESS: 3004 Kendall ST EXPIRES: 07/01/2018 JOB DESCRIPTION: Residential Re—roof to install Tamko Heritage asphalt shingles with 31 sq. 11 by 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 applicable municipal codes, policies and procedures, and that 1 am the legal owner or have been authorized by the legal owner of the property nd am authorized to obtain this peimit and perform the work described and approved in conjunction with this r rt,,j further attest that a leggally authoriz d to include all entities named within this document as parties to the work to be III ,nne aid that all Vork t be ertormed is dis se this document and/or its' accompanying approved plans and specifications. A A 4)C' 7 1.7 Signature of O �R 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. 7, 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 maybe 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 pen -nit. 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 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 or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of C'�Auilding Official U 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 insptimerequest@ci.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. Dane Lovett From: no-reply@ci.wheatridge.co.us Sent: Tuesday, June 20, 2017 9:12 AM To: Permits CommDev 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. 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. Permits are currently being processed within 3-5 business days, 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. 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? Lk) f/ v1vey How many dwelling units Single Family Home L � FrP t / I / (� are on the property? C �- 71l3l /t Z PROPERTY INFORMATION Property Address Property Owner Name Property Owner Phone Number Property Owner Email Address 3004 Kendall Street Florence Lillo 303 237 5996 Field not completed. Do you have a signed Yes contract to reroof this property? It will need to be provided at the time of permit pick-up. CONTRACTOR INFORMATION Contractor Name Rembrandt Enterprises Contractor's License 090236 Number (for the City of Wheat Ridge) Contractor Phone 303 619 3226 Number Contractor Email Address plgamble@hotmail.com (permit pick-up instructions will be sent to this email) Retype Contractor Email plgamble@hotmail.com Address DESCRIPTION OF WORK / Are you re -decking the No V/ roof? Description of Roofing Tamko Heritage Material Select Type of Material: Asphalt If "Other" is selected Field not completed. above, describe here: How many squares of the 31 material selected above? Does any portion of the No property include a flat roof? If yes, how many squares Field not completed. on the flat roof? 0) TOTAL SQUARES of all roofing material for this project Provide additional detail here on the description of work. (Is this for a house or garage? What is the roof pitch? Etc) Project Value (contract value or cost of ALL materials and labor) 31 House and garage, 4/12 pitch, removing 1 layer to deck and replacing $14,837.00 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 Philip Gamble Email not displaying correctly? View it in your browser. 3 o �n�nu�nr�nrarnnn�nu�nu�sn�nv nrrnrnnxnuu�sr�nrum Ku u f' trlu • J i u i lel u • u U I If t K'b 't' �unuan u��nu�nnn �nss�nn n snn�nr�n . 5 5 - Since 1985 - 5 S S 5 ®CROOFING NATIONAL i ONTRACTORS ASSoaArUr`r 5 S 5 enterprises ` MEMBER 5 5 10343 Federal Blvd J-428 Office: 303 453 0310 5 Westminster CO 802W GENERAL CONTRACTOR fax: 303 280 4745 5 S Submitted to ( ) ( ) Date , 5 5 Flo r-el t' S5 3; Street �i ( ) 5 3 0 Referred By 5 City, State, Zip 5 S 5� S 5We/hereby submit specifications and terms as follows: 51 5, J SHINGLES:30 r. ❑ Brand 1` �t g colorIns 5 RemoveLayers ❑ Additional Layers per square Si S! _30 # Base Felt ❑ Decking Repair Sheet Linear Foot �S C1,QSed Valley ❑ Decking Install I5 5 Y Drip Edge I� Low Slope —Ir �-- d�"It, 0 S ipe Boots IF 'Vent Jacks 5 , Flashing q_G -e d, -e L0' Roof Paint17 IF 5 Remove Debris & Magnetically Sweep Property (Ridge 5 5� 5 FI/Ventitation ar p� { Q 5 ❑ SIDING: Style Color Profile '5 =_J Wrapping ❑ Insulation I51 10 ❑ Facia ❑ Soffit i GUTTERS: Color 2/Downspouts Screens �I y; !AZimdaw S h 51 S Per final insurance settlement, insured pays only deductible + BINDING ARBITRATION: Any unresolved dispute between the �, i } parties hereto shall be submitted, according to rules then in 0 SI 5 effect, for arbitration by the Better Business Bureau." �P � DEFAULT: Your acceptance of this agreement provides 5 Rembrandt Enterprises lien rights to the property until the 5i !I account is paid in full. Amounts due in default will be charged 1% t 11 interest per month, and if such default is placed for collection, 1 st Payment tooa4;5I i property owner further agrees to pay all costs of such actions p2nd Payment including, limited r X51 but not to attorney, court, or tiling fees. I 3rd Payment ADDITIONAL TERMS AND CONDITIONS ON REVERSE Submitted By: �5 4CCeptaece of C040OCt; 5 The specifications, conditions and costs contained i Signature: c L(, ` � �-'�' 2Date. +herein are satisfactory and hereby accepted. 9 �, -�-�- Payments will be made upon completion of each trade. The workmanship warranty begins upon com- Signature: Date: S! pletion and is void if payment terms are not met. 5 City of " Wh6at �idge COMMUNITY DEVELOPMENT 7500 W. 29th Avenue * Wheat Ridge, CO 80033 * O: (303)235-2855 * F: (303)237-8929 Contractor Waiver for Workers' Compensation Insurance I, (print your name), No 6't, verify that I am the sole owner or partner of (company name): (IAA�4(-A Q r k AAJ�4 <1 C which has no employees and is not required by the State of Colorado to carry workers' compensation insurance. I further state that if I hire subcontractors, they are in compliance with the State of Colorado Workers' Compensation insurance requirements and have obtained the required contractor's business license from the City of Wheat Ridge. Signature: Date: �7 v % b —,CJ 0 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: -r—lb Job Address: t,0y Q (� 154— Permit Number: 70 30-09' ❑ No one available for inspection -.-Time A IPM Re -Inspection required: Yes No When corrections have been made, ca*for re -inspection at 303-234-5933 Date:-7/1Inspector: �OAJ Gi lbr1 __ DO NOT REMOVE THIS NOTICE r 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: XOF Job Address: S0 Uq S IL Permit Number: _Z u1 -7u SUy `y ❑ No one available for inspection: Time ��` AM/PM Re -Inspection required: Yes &p When corrections have been made, call for re -inspection at 303-234-59 _71017' 33 Date: Inspector: r 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 XuF Inspection Type: Job Address: '1>0U ` ( ��,, !� S Permit Number: 2 ul 7u Svy y N ❑ No one available for inspection: Time AM/PM Re -Inspection required: Yes When corrections have been made, call for re -inspection at 303-234-5933 Date: _716117 Inspector: rW DO NOT REMOVE THIS NOTICE CITY OF WHEAT RIDGE Building Inspection Division r (303) 234 -5933 inspection line (303) 235 -2855 Office • (303) 237 -8929 Fax INSPECTION NOTICE Inspection Type: AavF Job Address: 355V°✓ 6��wrJ,q-e/ r Permit Number: a ❑ No one available for inspection: Time ,' /c <ZW/PM Re- Inspection required: Yes o - When corrections have been made, call for re inspection at - 234 - 5933 Date: lP /S /o Inspecto DO NOT REMOVE THIS NOTICE ' = 14 ' City of Wheat Ridge W HEgT City of Wheat Ridge Building Division Date: 7500 W. 29" Ave., Wheat Ridge, CO 80033 Office: 303 - 235 -2855 * Fax: 303 - 237 -8929 Plan M ° Inspection Line: 303 - 234 -5933 / °rocxr.° Permit #: l C!l.�G� • Building Permit Application Property Address! 3 0 l, q k-2 h o1 c( �R a /,- Property Owner (please print): E I p r' - elVC2 L I` l�� Phone:3 '- 5 Mailing Address: (if different than property address) Address: City, State, Zip: Contractor: P— 6o d t-- Contractor License #: 0 9a a-3 Jo Phone: �3 b ( c ( 22 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): Construction Value: $ 1 7 R _ Description of work- (as calculated per the Building Valuation Data sheet) A � dx tee— 3 Q ��,`J X �t ��>:% Plan Review (due at time of submittal): b Say `�En.Wicp 114, r - 9-e/ I "NS� -c ,ll a. -P)y 1VIc)A -ed dN Iv clop's Sq. Ft./L.Ft added: Squares 32-- BTU's Gallons Amos OWNEpi TRACTOR 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 1 under this permit. Plans subject to field i nspection. CIRLCE ONE:: (D (0))WNER) CO NTRACTOR or PERSONAL REPR NTATIVE of NER) ( CONTRATOR) /4 PRINTNAME: P hr r l r /VI SIGNATURE: Date: