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HomeMy WebLinkAbout3940 Balsam StreetCity of Wheat Ridge Residential Roofing PERMIT - 201701460 i PERMIT NO: 201701460 ISSUED: 06/02/2017 JOB ADDRESS: 3940 Balsam ST EXPIRES: 06/02/2018 JOB DESCRIPTION: Reroof single family home - 38 squares *** CONTACTS *** OWNER (303)909-6036 DISNEY KRISTINE SUB (303)762-0089 Heyward C. Oliver 019720 Five Sons Roofing *** 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: 15,600.00 FEES Total Valuation 0.00 Use Tax 327.60 Permit Fee 299.40 ** TOTAL ** 627.00 *** 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€rms 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. r Df_ �1.�a nJ�INSP CTION RECORD t� INSPECTION REQUEST LINE: (303) 234-5933 Occupancy/Type Inspections will not be perfonned unless this 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 Concrete Encased Ground (CEG) Foundation / P.E. Letter Do Not Pour Concrete Prior To Approval Of The Above Inspections Underground/Slab Inspections Date Inspector Comments Initials Electrical Sewer Service '�''lUrfitiii!g rin Runt ('_near I Inrlarnrnttnd nr Rpinw/ln_Slah Wnrk Rrinr Tn Annroval Of The Above lnsr)eciions Rough Inspections Date Inspector Initials Comments Wall Sheathing Mid -Roof lb 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 ca.. 303-235-2861. For fire ir-,Fpectic rs contact the Fire Protection District for your projeci. 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. "For Inspection Time Window - Please email InSptimerequeSl@Ci.Wheatridge.CO.US by 8:00 A.M. the morning of the inspection with the property address in the subject line of the email. Time window is based on the inspector's route. Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued Protect This Card From The Weather City of Wheat Ridge Residential Electric PERMIT - 201701614 PERMIT NO: 201701614 ISSUED: 06/06/2017 JOB ADDRESS: 3940 Balsam ST EXPIRES: 06/06/2018 JOB DESCRIPTION: Install new mast through roof, install new 200 amp disconnect, install new sub panel in house *** CONTACTS *** OWNER (303)909-6036 DISNEY KRISTINE SUB (303)842-4505 Felix H. Keil 170256 Tesla Electric Company *** 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: 2,650.00 FEES Total Valuation 0.00 Use Tax 55.65 Permit Fee 93.35 ** TOTAL ** 149.00 *** COMMENTS *** *** CONDITIONS *** Must comply w/ 2012 IRC & 2014 NEC. Subject to field inspection. 1, 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_permit, I further attest t I am ]legally authorized to include all entities named within this document as parties to the work to be performed and that o be permed is disclosed in this document and/or its' accompanying approved plans and specifications. Signature &f OWNER CONTRACTOR ircle one) Date s I . This permit was issued aon a in ormation 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 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 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, an violation of any provision of any applicable coder or any 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. 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. 1t(,5(AM'hINSP CC O CORD (C INSPECTION REQUEST LINE: (303) 234-5933 Occupancy/Type Inspections will not be performed unless this 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 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. Concrete Encased Ground (CEG) Foundation / P.E. Letter Lath / Wall Tie Do Not Pour Concrete Prior To Approval UT I ne ADove inspections Underground/Slab Inspections Date Inspector Initials Comments Electrical 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. Sewer Service Plumbing Lath / Wall Tie 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 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 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 Rough Grading Final Window/Doors Insulation Final Building Drywall Screw / Nail 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. 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. **For Inspection Time Window — Please email inSptimereguest@Ci.Wheatridge.CO.US by 8:00 A.M. the morning of the inspection with the property address in the subject line of the email. Time window is based on the inspector's route. Occupancy Is Not Permitted Until A Certificate of Occupancy Is Issued Protect This Card From The Weather ( CITY OF WHEAT RIDGE :*Building Inspection Division (303) 234-5933 Inspection line _��9(303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Job Address: 31? 0 i�c� 54in Permit Number: 401701 q6o ❑ No one available for inspection: Time f . IAPM L, Re -Inspection required: EylYes� No When corrections have been made, call for re -in ection at 303-234-5933 r Date: ll Inspector: lI DO NOT REMOVE THIS NOTICE ► A ,r City of Wheat Ridge Residential Roofing PERMIT - 201701460 PERMIT NO: 201701460 ISSUED: 06/02/2017 JOB ADDRESS: 3940 Balsam ST EXPIRES: 06/02/2018 JOB DESCRIPTION: Reroof single family home - 38 squares *** CONTACTS *** OWNER (303)909-6036 DISNEY KRISTINE SUB (303)762-0089 Heyward C. Oliver 019720 Five Sons Roofing *** 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: 15,600.00 FEES Total Valuation 0.00 Use Tax 327.60 Permit Fee 299.40 ** TOTAL ** 627.00 *** 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€lms 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. PERMIT N0: JOB ADDRESS: JOB DESCRIPTION City of Wheat Ridge Residential Roofing PERMIT - 201701460 201701460 ISSUED: 06/02/2017 3940 Balsam ST EXPIRES: 06/02/2018 Reroof single family home - 38 squares 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 pro erty andm authorized to obtain this permit and perform the work described and approved in conjunction with this ermit. I further attest t I am . lly authorized to include all entities named within this document as partes to the work to be perfo;ze and that all w e n d�ased in this document and/or its' accompanying approved plans and specifications. nate of OWNER or CONTRACTOR (Circle one) Date `phis 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. 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. 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 andprocedures 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. 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. 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. 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 ordmartce or regulation of this jurisdiction. Approval of work is subject to field inspection. A - li Signature of Chief Building Official 1 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. "T•po City of Wheat Ridge Building Division Date: m 7500 W. 29th Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Plan #: CC�ORPOO Inspection Line: 303-234-5933 ai '1 O)i Permit M a/ l/ Building Permit Application Property Address. \��r� 140 N Property Owner (please print): (' 1 "4 n C L5 n e Phone:,3Q"3 -clog, Q()3U Mailing Address: (if different than property address) Address: City, State, Zip: Contractor: Contractor License #: Phone: ,503 U0 0 ec�q Sub Contractors; Electrical City License #: Company: Plumbing City License #: Company Mechanical City License #: Company: Exp. Date: Exp. Date: Exp. Date: Approval: Approval: Approval: Use of space (description): Description of.work: IConstruction Value: $,Lai 624n24;-�-- I (as calculated per the Building Valuation Data sheet) I Plan Review (due at time of submittal): $ I Sq. Ft./L.Ft added: am— Squares �_ BTU's Gallons Amps OWNERICONTRACTOR 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: S L� V�,r SIGNATURE: Date: LD ZONING:COMMENTS: =Zoning; Reviewer. PUBLIC 'WORKS COMMENTS; Reviewer BUILDINGDEPARTMENT COMMENTS: Reviewer: ftRE DEPARTMENT:: q appfoved wPcomments .o disbpproved City of Wheat Ridge Building Permit Submittal List The following items are required for the single- or two family building permit submittal for the property located at If any of the required items are not included in the submittal, the submittal will be considered incomplete and returned immediately without review. This sheet must be submitted with the building permit application. Please initial beside each required item, signifying that it has been included. Review Required by: ❑ Building ❑ Planning ❑ Public Works SUBMITTAL DOCUMENTS: Plans: ❑ Three (3) full-sized (24"x 36") plans (Contents of plans detailed in the Single- and two-family handout) — yellow heading ❑ Three (3) stamped sets of foundation plans. ❑ Three (3) copies of a grading and erosion control plan. ❑ One (1) copy of a soils report. DOCUMENTATION: ❑ One (1) completed building permit application. ❑ One (1) property deed. ❑ One (1) certified survey or Improvement Location Certificate. ❑ Proof of utility availability (form provided by city). ❑ One (1) building permit submittal list. ❑ One Grade/Fill permit. The following items are required for the commercial or multi -family building permit submittal for the property located at . If any of the required items are not included in the submittal, the submittal will be considered incomplete and returned immediately without review. If you had a pre -application meeting with Staff, you must submit the checklist you received. Otherwise, this sheet must be submitted with the building permit application. Please initial beside each required item, signifying that it has been included. Review Required by: ❑ Building ❑ Planning ❑ Public Works SUBMITTAL DOCUMENTS: Plans: ❑ Four (4) full-sized (24"x 36") plans (Contents of plans detailed in the Commercial & Multi -family handout) — pink heading ❑ Two (2) copies of a final drainage report and plan OR Two (2) copies of a drainage letter and plan ❑ Two (2) copies of a grading and erosion control plan ❑ Two (2) copies of a traffic impact study OR Two (2) copies of a trip generation study DOCUMENTATION: ❑ One (1) completed building permit application. ❑ One (1) property deed. ❑ One (1) certified survey or Improvement Location Certificate. ❑ Proof of utility availability (form provided by city). ❑ One (1) building permit submittal list. 0 One Grade/Fill permit. City of Wheat Ridge Residential Electric PERMIT - 201701614 PERMIT NO: 201701614 ISSUED: 06/06/2017 JOB ADDRESS: 3940 Balsam ST EXPIRES: 06/06/2018 JOB DESCRIPTION: Install new mast through roof, install new 200 amp disconnect, install new sub panel in house *** CONTACTS *** OWNER (303)909-6036 DISNEY KRISTINE SUB (303)842.-4505 Felix H. Keil 170256 Tesla Electric Company *** 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: 2,650.00 FEES Total Valuation 0.00 Use Tax 55.65 Permit Fee 93.35 ** TOTAL ** 149.00 *** COMMENTS *** *** CONDITIONS *** Must comply w/ 2012 IRC & 2014 NEC. Subject to field inspection. 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 the property and am authorized to obtain this permit and perform the work described and approved in conjunction with thispermrt. 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, 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, any violation of any provision of any applicable code or�nj�grdinance or re ulation of t is 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. City of p.. j,dg,e- ,OAA�WheatUNITY DEVELOPMENT Building & Inspection Services Division 7500 W. 291h Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-23778929 Inspection Line: 303-234-5933 Email: permits(a)ci.wheatridge.co.us FOR OFFICE USE ONLY Date: Plan/Permit #)0 � 0 l I 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: 3 q-�-1iJ ko(#'n &_ set ✓n gh-0 Q' - Owner K� r Property Owner Email: Ar;Sft n PC,(; Mailing Address: (if different than property address) Address City, State, Zip: Architect/Enginser: Architect/Engineer E-mail: Phone: Phone: :5U�5 V Y - Contractor:E/i� i R1141L r X - a/1 Contractors City License #: t rJ Phone:` Contractor E-mail Address: Sub Contractors: Electrical: et i-1 Plvk L ('Jeyrt- Plumbing: W.R. City License # W.R. City License # Other City Licensed Sub: City License # Mechanical: W.R. City License # Other City Licensed Sub: City License # Complete all information on BOTH sides of this form 6 ❑ COMMERCIAL g RESIDENTIAL Description of work: (Check all that apply) ❑ NEW COMMERCIAL STRUCTURE 19 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.) ❑ MECHANICAL 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. Ft./LF Amps :O Squares Btu's Gallons Other iProject Value: (Contract value or the cost of all materials and labor included in the entire project) s 2650--'00 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. CIRCLE ONE: (OWNER)t/C^O_N(TRACTOR or (AUTHORIZED REP ENTATIVE) of (OWNER) (CONTRACTOR) PRINT NAME: I Y V3'1 SIGNATURE: DATE: ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: PUBLIC WORKS COMMENTS: Reviewer: PROOF OF SUBMISSION FORMS Fire Department ❑ Received ❑ Not Required Water District ❑ Received ❑ Not Required Sanitation District ❑ Received ❑ Not Required DEPARTMENT USE ONLY OCCUPANCY CLASSIFICATION: TYPE OF CONSTRUCTION: SPRINKLERED: OCCUPANT LOAD: Building Division Valuation: $ A i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE 4--, . Inspection Type: Q r, F Job Address: / V 6 ,P Permit Number: a2.c>/ 7 h. l q 4,5 D r} r t7 (a? r ❑ No one available for inspection: Time (r) ` ' r, AM/PM Re -Inspection required: Yes When corrections have been made, call for re -inspection at 303-234-5933 Date: -6/2/17 Inspector: P V 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: IF)" A 161NO 4---F / Job Address: 31YO 644SAr7 37 Permit Number: Z © 1-7o/ ( / �/ ❑ No one available for inspection: Time 13��® A Re -Inspection required: Yes o When corrections have been made, call for re -inspection at 303-234-5933 Date: /G.// Inspector: 4,1-1 DO NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE _1�9�Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: /° ► ) J) Job Address: I(M LS"AM Permit Number: 2D 1—) OI y �3 (2 I C141-16 T' (Mb- Ser Ce-Ic4�-r AT Flnl��- -�. ❑ No one available for inspection: Time OTAN(/P4 Re -Inspection required: Yes No 'When corrections have been made, call for re -inspection at 303-234-5933 16l �� Date: � Inspector: DO NOT REMOVE THIS NOTICE zalil=� roll a- MMS Building Permit Application Pro'OMci 'S" 3� S - ,rty, . ,res : 81a � tset vn 04e� • MEEM��� Address: hi one: W. M. no.- 303 - 945 IS I C I Electrical: W.R. City License # M Mechanical: WR City License 4 . .. . ....... .... Complete all information on BOTH sides of this form Aug 1014 0 2:41 p p.3 FORM (M) 414-02.1123 XCEL ENERGY ADD ss� 132594 �y CITY -TOWN OR COUNTY w,8 FLOOR API NO CUSTO R WE (PRINT) ACTION TAKEN R ❑ NO SHUT OFF OWNE TENANT AGENT E] OTHER. SPECIFY ❑ APPLIANCE OFF ' ❑ BOTH APPL & METER OFF e „1, m ❑ METER SHUT OFF C � BE - CONDITION TO BE CORRECTED D HAZARD t? REATE AS SHOWN BELOW CS AN IMMEDIATE HAZAgp, THIS EQUIPMENT MUST NOT BE BACK IN BUILDING SERVICE UNTIL REPAIRS AND ODE AND Y QUALIFIED INSPECTION HAVE BEEN MADE B A CONTRACiOq. CONTACTYOUR LOCAL BUILDING DEPARTMENT FOR CODE ANO PERMIT REQUIREMENTS PRIOR TO PERFOgMING REPAIR RAC N�ND TYPE OFAPPLIANCE pp C TO BE CORRECTED f r racceo Br FOR FURTHER INFORM N, Q'N�; tl J•- CUSTOMER O IEa i. ATE UPANT SIONgTURE � i .DATE RELATIONBHIA OF OCCUPANi.TO CUSTOMER ;I