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Home My WebLink About4215 Balsam Street�'%�-t 5 f ��S(�r�-3� 1 N S P E C 1 NIR CORD Occupancy/Type INSP TION ONLINE FORM: http://www.ci.wheatridge.co.us/inspection INSPECTION REQUEST LINE: (303) 234-5933 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) 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 Sewer Service-/ 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 _ 7 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 - 201706668 PERMIT NO: 201706668 ISSUED: 08/28/2017 JOB ADDRESS: 4215 Balsam ST EXPIRES: 08/28/2018 JOB DESCRIPTION: Residential Re -roof to install Asphalt Shingles for 22 sq House *** CONTACTS *** OWNER (515)689-7705 HANIFEN JAMES E IV SUB (720)726-6775 Nicholas Welle 090129 Colorado Continental 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: 5,654.00 FEES Total Valuation 0.00 Use Tax 118.73 Permit Fee 140.90 ** TOTAL ** 259.63 *** 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. Midroof & Final Roof inspections for ROOFS OVER 6/12 PITCH: 3rd party inspection will be required, 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. PERMIT NO: JOB ADDRESS: JOB DESCRIPTION City of Wheat Ridge Residential Roofing PERMIT - 201706668 201706668 ISSUED: 08/28/2017 4215 Balsam ST EXPIRES: 08/28/2018 Residential Re—roof to install Asphalt Shingles for 22 sq House 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 roperty and am authorized to obtain this permit and perform the work described and approved in conjunction with this_permrt. I further attes that I am legally authorized to include all entities named within this document as parties to the work to be performed and that wor o e performed is disclosed in this document and/or its' accom anyi approved plans and specifications. 0 Signature of OR or ffithose CTOR (Circle one) Date' I. This permit s issued bainformation provided in the permit application and accompanying plans and specifications and is subject to the compliance 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 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, an violation of any provision of any applicable c apny� �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. Dan Schultz From: no -reply@ ci.wheatridge.co.us Sent: Thursday, August 24, 2017 10:30 AM To: CommDev Permits Subject: Online Form Submittal: Residential Roofing Permit Application Categories: Danny 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 (J residential roof? How many dwelling units Single Family Home lam' tN� are on the property? PROPERTY INFORMATION Property Address 4215 balsam st wheat ridge, co 80033 Property Owner Name james hanifen U Property Owner Phone 515-689-7705 Number (enter WITH dashes, eg 303-123-4567) 109 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 4215 balsam st.pdf Contract CONTRACTOR INFORMATION Contractor Business Name Contractor's License 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) colorado continental roofing & solar 0901291) 720-726-6775 7651 west 41 st wheat ridge, co Contractor Email Address dustinherrin@roofingprofessionals.com Retype Contractor Email dustinherrin@roofi ng professionals. corn Address DESCRIPTION OF WORK TOTAL SQUARES of �22 the entire scope of work: Project Value (contract value or cost of ALL materials and labor) Are you re -decking the roof? 110 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 22 part of the pitched roof? Describe the roofing asphalt materials for the pitched roof: Type of material for the Asphalt pitched roof. Provide any additional house 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. ill 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 jason metzig Email not displaying correctly? View it in Vour browser. 112 FATAL Customer Name s^1 r r/ I V P Li Date:f 1 j`� JobsiteAddress: Insurance Carrier: r- or-)"o,-IS�� ytl:5 ��'� �� Insurance Claim Phone CO Continental Roofing Rep: 1-1 -,a-{� ,,ustomer Email: 1 cun.l �° z4' 4q r , "�Ei InsJrance Coverage Provided Br. Allen Buchholz Insurance P.O. Box 4227 Olathe, KS 660634227 (720) 726-6775 Roofing Specifications Tear Off: 0 1 Layer ❑ 2 Layer ❑ Other Underlayment: ❑ 15# ❑ 30# ® Synthetic Shingle Manufacturer:e,� Shingle Type: Shingle Color s;-�H fp: Roof Vent Type: —❑ B'o'x ❑ Ridge ❑ Power ❑ Turbine Plumbing Stacks: ❑ 3n1 ❑ Lead ❑ Other Ice & Water Shield Per Code Valley: ❑ Ice & Water Shield ❑ W Pan Hip & Ridge: Standard ❑ Enhanced Metal Edge: ❑ To Match Existing ❑ Other Roof Decking: ❑ CDX OSB ❑ Other Attic Inspection: ❑ Yes ❑ No *Nailing Pattern to Meet or Exceed Manufacturer Specifications * NON NAILABLE SURFACE CLAUSE: Please note that any defective roof deck/plywood found during tear off of the existing roof covering must be replaced per state building code. Most insurance carriers do not cover this cost as part of your claim. Customer will be respsonsible for this cost at $50 per sheet which includes labor and materials. Special Instructions Customer Initial Clean All Gutters of Roof Debris Protect All Landscaping Furnish Building Permit Cleanup Daily Roll Magnet Through Yard 5 Yr Workmanship Warranty Provided Upon Final Payment Approximate Start Date: > 2P 913-390-9011 Siding ❑ Aluminum ❑ Vinyl Size: / ❑ Dutch Lap ❑ Straight Brand: Color: Fascia: Soffit: Tyvek: ❑ Yes ❑ No Insulation: ❑ Yes ❑ No Gutters/Downspouts ❑ 5" 116" Gutter Color: ❑ 2x3" ❑ 3x4" Downspout Color: Additional Notes 9 / a fi Payment BreAdm n F e rl Insurance Claim Amount 1-27 Supplement Amount (if needed) At * Homeowner Upgrade Amount �-L O&P for Complexity of Multiple Trades Approximate Finish Date: .1& ,0141 � Total Cost (tax included) Terms: This agreement is contingent upon insurance company approval and agreed price. This agreement does not obligate the customer or Colorado Continental Roofing & Solar in any way unless it is approved by customer's insurance and accepted by Colorado Continental Roofing & Solar. Customer's signature below signifies acceptance of all terms and conditions of this Agreement, including all terms on the reverse side hereof. Colorado Continental Roofinp & Solar will seek approval from insurance company for any necessary supplements outside of the original scope of work. Customer's 'out of pocket expense is not to exceed deductible and any upgrades. Payment due upon completion of each trade Customer Signature Date C.C. .Rep Signature Date RIGHT OF CANCELLATION PURSUANT TO FEDERAL REGULATION AND COL. REV. STAT. § 5-3-403: YOU, THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. RIGHT OF CANCELLATION PURSUANT TO COL. REV. ST. § 6-22-104: YOU, THE BUYER, MAY CANCEL THIS AGREEMENT AT ANY TIME WITHIN 72 HOURS AFTER YOU HAVE BEEN NOTIFIED THAT YOUR INSURER HAS DENIED YOUR CLAIM TO PAY FOR THE GOODS AND SERVICES TO BE PROVIDED UNDER THIS AGREEMENT. Company shall hold in trust any payment from Customer until Company has delivered the materials to your property or has performed a majority of the work on the property. CO 01.15 City of Wheat Ridge Residential Roofing PERMIT - 201706668 PERMIT NO: 201706668 ISSUED: 08/28/2017 JOB ADDRESS: 4215 Balsam ST EXPIRES: 08/28/2018 JOB DESCRIPTION: Residential Re -roof to install Asphalt Shingles for 22 sq **REVISION**Adding Redecking; Added valuation: $2,000.00 *** CONTACTS *** OWNER (515)689-7705 HANIFEN JAMES E IV SUB (720)726-6775 Nicholas Welle 090129 Colorado Continental 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: 7,654.00 FEES Total Valuation 0.00 Use Tax 160.73;`` a Permit Fee 172.60.:4 a r ** TOTAL ** 333.33 *** 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. Midroof & Final Roof inspections for ROOFS OVER 6/12 PITCH: 3rd party inspection will be required, 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. City of Wheat Ridge Residential Roofing PERMIT - 201706668 PERMIT NO: 201706668 ISSUED: 08/28/2017 JOB ADDRESS: 4215 Balsam ST EXPIRES: 08/28/2018 JOB DESCRIPTION: Residential Re -roof to install Asphalt Shingles for 22 sq **REVISION**Adding Redecking; Added valuation: $2,000.00 I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, appica bble building codes, and all applicable municipal codes, policies and procedures, and that I an the legal owner or have been authorized by the legal owmer 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 yis' accompanying approved pIans and specifications. Signatu1fe4-/0VVAR or CONTRACTOR (Circle one) Dat I, Thi rmit 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 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 change of the natural flow of water without prior and specific approval. 5. The pen -nit 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 oe ting of a permitshallnot be construed to be a permit for, or an approval of, an violation of any provision of any applicable code o ordman r ul '6n f this jurisdiction. Approval of work is subject to field inspection. i Signature of Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. City of Wheati(ge COMMUNITY DEVELOPMENT Building & Inspection Services Division 7500 W. 29th Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Email: permits(a)ci.wheatridge.co.us FOR OFFICE USE ONLY Date: Add to Permit # Building Permit Revision/Amendment Application *** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: C fA Property Owner (p/ease print): Phone: J t S ` y S 7 Y-7�' L4'0�e'-2 k 3 �� Property Owner Email: i r.,, v►.. e-�- Mailing Address: (if different than property address) Address: Citv. State. Zi 4.11; G'► lc i Contact Person: t e Phone: -7 Zd Rc"/�> Contractor: Contractors City License #: Contractor E-mail Address: 0 Phone: 7 Zo Please Note: Additional valuation must include all general and subcontracted work to be performed related to the revisions and/or amendments declared in the description of work and which were not included in the original permit valuation. If revisions or amendments increase the original valuation, additional fees will be due at the time of approval. Depending on the scope of work, additional plan review fees may be due upon approval ($60.00 an hour - 2 hour minimum). Description of revised/amended work: Sq. Ft./LF 59 Amps Btu's Gallons Squares ,� Other Additional Project Value: (Must include all general and subcontracted work to be performed related to revisions/amendments described above) $ 2Uoa 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 appli CIRCLE ONE. (OWNER) (CONTRACTOR) or PRINT NAME: 15�-StXpC��L 1 `� SIGNATURE: DEPARTI 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 REPRESENTATIVE) of (OWNER) (CONTRACTOR) USE ONLY DATE: OVA< -611 OCCUPANCY CLASSIFICATION: Building Division Valuation: $ City of Wheat Ridge .� Residential Plumbing PERMIT - 201704714 PERMIT NO: 201704714 ISSUED: 07/25/2017 JOB ADDRESS: 4215 Balsam ST EXPIRES: 07/25/2018 JOB DESCRIPTION: Sewer repair 50 ft frontyard 4 in line *** CONTACTS *** OWNER (515)689-7705 HANIFEN JAMES E IV SUB (303)519-0240 R. Andrew Russell 120161 The Elite Pipe MD *** 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: 5,200.00 FEES Total Valuation 0.00 Use Tax 109.20 Permit Fee 140.90 ** TOTAL ** 250.10 *** COMMENTS *** *** CONDITIONS *** ALL sewer repair/replacements for which a permit is issued MUST be inspected by and receive written approval from the City of wheat Ridge BUILDING DIVISION, regardless of inspection by any Sanitation District representative. Inspection and approval of work by any Sanitation District representative DOES NOT grant authority to cover work without the approval of the Building Division. **For trenchless sewer replacements - The contractor will verify proper slope of new sewer piping in conformance with the IRC and IPC of 1/4 inch per foot unless otherwise allowed specifically by the applicable code. The plumbing contractor will provide verification of proper slope and drainage in writing as a condition of approval of the permitted work.** PERMIT NO: JOB ADDRESS: JOB DESCRIPTION City of Wheat Ridge Residential Plumbing PERMIT - 201704714 201704714 ISSUED: 07/25/2017 4215 Balsam ST EXPIRES: 07/25/2018 Sewer repair 50 ft frontyard 4 in line 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 1 am t%e 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 Flans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, po Flans and procedures. 2. Thts.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 Budding 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, an 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 Chief Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. City of f W heat }�idge muNiTy DEVELOPMENT Building & Inspection Services Division 7500 W. 29th Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 FOR OFFICE USE ONLY Date: 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: �-1 J� ��✓✓� k �e�k Q; �� Property Owner (please print): 3�v-1 G., k k k 1 Phone: Jc l 5 - 1451 ' i 34 Property Owner Email: Mailing Address: (if different than property address) Address City, State, Zip: Architect/Engineer: Architect/Engineer E-mail: Contractor: -T k 1�' " fit, ` P Contractors City License #: Phone: Phone: _7:Z_0- 662- 4 3151 Contractor E-mail Address: Civ d tt 4r c, e pe, rvLA . (_0 ^4 Sub Contractors: Electrical: W.R. City License # Other City Licensed Sub: City License # Plumbing: W.R. City License # Other City Licensed Sub: City License # Mechanical: W.R. City License # Complete all information on BOTH sides of this form 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.) ❑ 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.) 5o' v-ew� �esv: Le. ��Po-; Lo"� FrpV• k/ c- E4 t• Sq. FtAF Amps Btu's Squares Gallons Other Project Value: (Contract value or the cost of all materials and labor included in the entire project) $ 5Z, C) .o 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 applicaf CIRCLE ONE: (OWNER) (CONTRACTOR) or (AUTHORIZED REPRESENTATN of (OWNER) (CONTRACTOR) PRINT NAME: SIGNATURE: � DATE: / Z'4 11-7 DEPARTMENT USE ONLY ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer. PUBLIC WORKS COMMENTS: Reviewer: PROOF OF SUBMISSION FORMS Fre Department ❑ Received ❑ Not Required Water District ❑ Received ❑ Not Required Sanitation District ❑ Received ® Not Required OCCUPANCY CLASSIFICATION: Building Division Valuation: $ i CITY OF WHEAT RIDGE _:�9rBuilding Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: L1 V Cl - i- " c-,1 Job Address: y'd ► S Ao, ISO, ,1 S �- Permit Number: 2 0 7 e 6 iP to g C I�� 3r—ca r i n s, ",;Tv n twec 7T7n srte r �^ 'r^ee a c c E ❑ No one available for inspection: Time ` = 3 0 PM Re -Inspection required: Yes No When corrections have been made, call for re -inspection at 303-234-5933 Date: fo 6r I -7Inspector: TL DO NOT REMOVE THIS NOTICE 44, CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type:y U (.,- Job Address: a I r (3 Permit Number: n/ 7 p y-7 I LP ❑ No one available for inspection: Time / JA /PM Re -Inspection required(Yes No C ,")% %-yf� LA- When corrections have been made, call for re -inspection at 303-234-5933 R Date: �-!7 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: U Job Address: 1/2- /5-- 46-s4M S' ❑ No one available for inspectio Timeu I '' AM/PM Re -Inspection required: Yes UN When corrections have been made, call for re- i ction at 303-234-5933 Date: ' t _ . ' Inspector: v" L/ 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: A OL Permit Number: ao 1-70 & Z, & g Ef n ed U3 o f � ,roti I IJ - o b c o N � �► a i� ,1.G d j+l�,e �s �,e. rn • c� - d -o fo f Cy f1% t-" 1.- /1 _ P / e a , -.o ,' N (" , A ►,tel JGible 4-v Go♦i1n/.,1, ! ,ren, _ l9 1-c , el V c4c fly ❑ No one available for inspection: Time —d Lj AM PM Re -Inspection required: Yes Co When corrections have been made, call for re -inspection at 303-234-5933 J Date: C1 /6 Inspector: j j DO NOT REMOVE THIS NOTICE i CITAP*NEAT RIDGE _1�9�Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: 6 ) . j / S Job Address: Li -a/ s- Z . )cam.,, cl Permit Number: -P o i> c b(, L S ❑ No one available for inspection: Time I -,5-S7- AM PM Re -Inspection required: es No When corrections have been made, call for re -inspection at 303-234-5933 Date: S 3 r. Inspector: ` DO NOT REMOVE THIS NOTICE in Complete all information can BO H sides of this form Prop r ,r Address; 4* Property Owner (please print): Phone- , a Property Owner Enna# Mailing . (if different than property address Address. City, State, Zi Arch to Knoln4er E -mail: Phone: Contractor: Contractors City License f# : > Phone* Contractor E-mail dress: sub Contractors Electrical. Plumbing. ; l: Mechanical: WR City License # W.R. City License # W.R. City License # Other City Licensed Sub: Other City Licensed Sub: City License # Caty license # Complete all information can BO H sides of this form �' Ill! iiiiiilill 1111 • fr 0t t O f MW C4 ordinanc,� r t the r x r gad th0' 0 ' , ; 0 t ho valid P s to Maki In W.6 44 C 11 tll} 1 Wheat Ridge Build 1 it 1 n �� y; `��V1111i1 �? 1 1 } SS i�l �� tai i 1 11 i ",7r.. C h g X37 Work shall comply with the utl t type, location nd s pacin g 1cfllowin odes: 2012 1R , 2012 shall comply wifli 2012 IRC and IECC & 2014 NEC, 2014 NEC Water 1 ",1111 m r �irrest rs are equi ed Smoke alanns shall be required in at quick-closing valves R,2903,5. each sleeping doorn and outside each sleeping area per 012 IRC, Section 311 ('"'arbon inonoxide detector(s) shall comply with Section R 315 of 01 2102 IRC &seat more than 10' firom flic erarance of any sleeping room, Outlets are required to are- fault protected. All measurement in inches ENVIRONMEN"T "', I is onsu ing 4215 Balsam St, Wheat Ridge, Colorado 80033 Mr. Jim Hanifen Homeowner 4215 Balsam St Mr. Steve Shurtliff 12477 W Cedar Dr, Ste 101 Lakewood, CO 80228 (303) 378-1544 NKM31= Pro jectNumber: 11963 Conducted: March 2 6, 2015 APPROVED &6*4 to FiW Iftpediafts TABLE OF CONTENTS APPENDIX A Inspector & Firm Asbestos Certificates APPENDIX ff Analytical Data I PROJECT OVERVIEW On March 26, 2015, Mr. Steve Shurtliff with DS Environmental Consulting (DS) conducted a limit asbestos inspection and collected asbestos bulk-samples of suspect asbestos-containing materials (AC in support of kitchen renovations within the single-family residence located at 4215 Balsam St, Whe Ridge, Colorado. :9 IS on lazk a11>Ux;aU_T111"4Ma)11H116 4-faak'W Illt %A1.4 alvt� ctl�'U likaj navv vW11k'a1jL1m:1Uma1-KtL the other areas within the home. I UMNEM�� "Mom, did no onstit�te a full building inspection and does not fulfill the asbestos inspection requirements for structures that are to be demolished. MEE= I ro .111ttl#tw # DS has collected the appropriate number of bulk-samples to meet all regulatory requirements for t , classification and quantity of each homogeneous area. Some minor destructive sampling w- conducted; however, walls, columns and perimeter pipe chases were not broken into in order to loca t and quantify suspect ACM, It should be noted that additional ACM might be located in these and oth I inaccessible areas. 5.3 Analytical Procedures All asbestos bulk-samples were analyzed by a National Voluntary Laboratory Accreditation Program (NVLAP) accredited laboratory via Polarized Light Microscopy (PLM) for asbestos content (see Appendix Bfor laboratory report). ISD777 TMORC 11sla rea greater tnan Tw uniess it is re-analyzect utilizing Pe point-count method and verified to be less than 1%. Fj t application. The asbestos content of the bulk-samples collected within a homogeneous area can be applied to the entire homogenous area if they conform to the above characteristics and tile regulated minimum sample quantities of each type of material are collected and analyzed. 6.1 Material Friability A material can either be friable or non-friable. A friable material is one that, when dry, can be pulverized, or reduced to powder by hand pressure, a non-friable material cannot A non-friable material may become friable if its condition had deteriorated or has been impacted by forces that have rendered it friable. 6.2 Material Classifications I wi-Vil 6.3 Material Conditions 6.4 Sample Quantities DS collected at least the minimum number of samnles from each homoggineous area neces=X to 1 I =T UUNCI_IItCS Ule 111dLel LUIlIfUSIIII; CdCH 11#1111tg I Td as 777ft as Me MMuTTIS Ti Vacil oui:::: HTPM collected. Also listed is the classification, condition, friability and estimated quantity of material to be removed and/or disturbed, as well as the asbestos content vAthin each bulk-sample. Please see Appendix B: Analytical Data for the layer break-down of each bulk-sample. I �a f v F a � t G»? a� z c 2 ? tffi O as 4 ra ra r14 ra oom C cy) Restrict access • the area and post warning signs to prevent entry to the area by persons other than those necessary to respond to the incident In the event of an asbestos spill involving less than or equal to the trigger levels, the building owner or contractor should take the following non-mandatory steps: M A I I � ''FIN � I I 1 :1111 i I ME= DS can provide an Asbestos Project Design as well as fulfill the Colorado Asbestos Project Manag requirements for any asbestos abatement project, as applicable below. I WININNOW • • 1 4 U111"Im Lw • I lIffitans WIN OM @ DS Environmental Consulting 2015. All Rights Reserved. This document contains material protected under Federal Copyright Laws. No part of this document or any of its contents may be reproduced, copied, modified or adapted, without the prior written consent of the author and DS Environmental Consulting APPENDIX INSPECTOR FIRM S EST S CERTIFICATES Is Building ;p tor* llsovkl� Just M 1414 rx-pir"r ,Sense M :Z08S.. al APPENDIX ANALYTICAL DATA BE 4 -a I I a a :2 n nno'� 'z � "r m ekx E E �i I ol -1 0 CA PMT, ran 6 Oil 1 o t� U U zz z z JS 4 to -- -------------- z ----------- -------- - --- NZ a z z z z z z z z z z 2 cz TM vE f� 0� kn C� ON In C In 0� In ol kn ol 'n 1 - 1 1 �o 1 �0 In 1 0 In 1 4 , W) "0 W> 10 'n 0 0 C> C> 0 e 45 wi kn ---- -- --- - --- - -------- E Id tr 6 Oil 1 o t� U U zz z z I JS 4 I -d E5 0 r 83 14 i I I I E as I I I I■ st is Z Oil P4 z z A�" z Er- & Z c Ln CY ICY — ----- ----- as z z z z z z z z z z sa as Aj Z arx. kry kn 01 V s a V' 0� un 1:11 f) 0� Vn 01 vt 10 �o 10 In r en In ww vk an cx V5 C4 ij. - ------------ - st is Z Oil P4 z z A�" z Er- & Z c Ln m 5 8 CJ � aw 8 "In ,;� � t 2 ax wro N I cry ca POP .AMMA Iza M z ci cn as ai 21 'O rs ......... ...... L POP .AMMA Iza M z ci cn ai I I :I sz t o o E S 4- ,tz ,= F: v t oo V o l o C. C4 jt Ul V , g m u Jg in cd U tm in Z p co co cz < 2 - 0 4 tn 0 Cd t) r" to R 'o yyy C4 I Complete all information an BOTH sides of this for .. V?1'.,. a 0 s .11• Sm PAT Btu's Gallons - City of Wheat Ridge Residential Mechanic PERMIT - 110025 PERMIT NO: 110025 ISSUED: 01/11/2011 JOB ADDRESS: 4215 BALSAM ST EXPIRES: 01/11/2012 DESCRIPTION: Replace 50 gallon hot water heater * ** CONTACTS * ** owner 303/425 -8821 Fernando Nieto sub 720/833 -0601 Beverly Gorshern ** PARCEL INFO ** ZONE CODE: UA SUBDIVISION: 0804 USE: UA BLOCK /LOT #: 0/ ** FEE SUMMARY ** ESTIMATED PROJECT VALUATION: 1,516.00 FEES Permit Fee 40.00 m Total Valuation .00 Use Tax 27.29 ** TOTAL ** 67.29 a Conditions: Work shall comply with 2006 IRC & 2005 NEC. Per IRC Sec. R313, smoke detectors are required to be installed in every sleeping room, in hallways outside of sleeping rooms, and on every level of the structure. Carbon Monoxide detectors are required to be installed within fifteen(15) feet outside the entrance to each sleeping room. Subject to field inspections. 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 code's, 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 scrib and approved in conjunction with this permit. I further attest that I am legally authorized to include all entiti s named thin this document as parties to the work to be performed and that all work to be performed is disclosed in t 's and /or its' accompanying approved plans and specifications. of OWNER or CONTRACTOR 1. 2. 3. 4. 5. 6. Signature of gyf€P Aiilding Offical 02 -1981 CANDLELIGHT HEATING & AIR, INC -/,L / Date 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. 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. 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. 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, any violation of any provision of any applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field insrection. Date N REQUEST LINE: (303)234 -5933 BUILDING OFFICE: (303)235 -2855 MUST BE MADE BY 3PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. Y' T,City of Building & nspection Services Division 7500 W. 29 Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303 - 237 -8929 Inspection L ne: 303 - 234 -5933 Building Permit Application Property gcit�ess; t/a/ Date. Plan # Permit # Property Ow er (please print): / ly/ e 14:2 Phone: 3� 88 Z Mailing Addr ss: (if different than property address) Address: City, State, Zi Contractors ity License #: Phone: - S SubGontrd „- ° ts? Electrical Plumbing: Mechanical: City License City License # City License # Contract Value: ,��/ 11,ra Ave h. Review Fee (due at time of submittal): quares 1 1 BTU's Gallons — Amps S Ft. 1 $ _ _ 1 OW E= NTRACTOR SIGNATURE OF UNDERSTANDING' AND AGREEMENT I hereby cent that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or mgula ons of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations ma a are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility roompliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this appliea5o ; 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 a horized by the legal owner of any entity included on this application to list that entity on this application. CIRCLE GIVE: (OWNER) CTO or (AUTHORIZED REPRESE�eJ (OWNER) (CONTRACTOR) T.a�ed TLSTSE6EOE 1119I1_3iiawo WUGTt9 TTOZ IT Uer. ✓rQ�� / DATE: "// PR NAME C_9�Zr --- 7777777777777777777= D6P11ltTMENT t1S>r QNL f 77777 ZOtJING Ca'td ri7G Put tn)l4q, ,EP F e"r Rfo MM ENTS r PUBIJG WARS CgR},IyENTS ACCI)P`}4NCY FlRE DEPARTYtA t}`F Q approYfd w/ comments ❑ disapproved ❑ no reviewrQgwred ` -- Bldg Valuation: _$ T.a�ed TLSTSE6EOE 1119I1_3iiawo WUGTt9 TTOZ IT Uer. F m City of Wheat Ridge Residential Roofing k PERMIT -070715 PERMIT NO: .070715 ISSUED: .07/13/2007 'JOB ADDRESS:. 4215 .BALSAM. ST EXPIRES: 01/09/2008 DESCRIPTION: T /O;. reroof 30 lb; dimensionals, 19 sqs. ** *CONTACTS. * ** p owner :303/995 -6943 Nancy Kunz gc 303 /466 - 0161 Bernie Reitz O1 - 9543 Reitz Roofing, Inc. "..sa.. PARCEL INFO ** - '.ZONE CODE: -: UA USE: UA SUBDIVISION: 0325 BLOCK /LOT #: 0/ ` ** FEE SUMMARY. ** ESTIMATED PROJECT. VALUATION: 3,711.00 FEES Permit Fee.. '126.50 Total Valuation : .00 Use Tax 66.80 �. ** TOTAL ** 193.30 Comments U; I hereby :certify that the setb k di tances proposed by this permit application are accurate, and do not violate applicable ordinances, rules or regulatio a of. he City of wheat Ridge or covenants, easements or : restrictions of record; that all measurements shown, and allega 'ion made are accurate; that I have read and agree to abide by all conditions printed on this :appla, ion an t Iassume fu sibility for compliance with the Wheat Ridge Building Code (I.B.C) and all other. p, "cable Wheat i Ordina es, r. work .under this permit. Plans subject to field inspection. .Signature of contractor /owner date F 1.. This permit was issued in.. accordance with the provisions set forth in your application and is subject . to the laws of the ti4 State of Colorado . and to the .Zoning Regulations and .Building Codes of Wheat Ridge, Colorado or any other applicable ordinances of the City. - 2. This permit shall expire 180 days from the issue date. Requests for an extension must be received . prior to expiration .date. An extension may be granted at the discretion of the Building Official. 3. If this permit expires, :a new permit may be acquired: for a fee of one-half the amount normally required, provided no changes have been or will be made in the original plans and .specifications and any suspension or abandonment has not c exceeded one (1) year. - If changes have been or if suspension or abandonment exceeds. one (1) year, full fees shall be paid for a new permit. -. 4. No work of any manner shall be done . that will change the natural flow of water causing a drainage. problem. 5 Contractor . shall notify. the Building Inspector twenty -four (24) hours in advance for all inspections and shall receive .written approval on inspection . card before proceeding with successive phases of the '. job. m: 6 The issuance .. of w / � er or the approval of drawings and specification' shall not be construed to be a permit for, nor an .approval. q IVY.. olation of the provisions of the building codes or any other ordinance, law, rule or regulation._ yp All plan rev to field inspections. Signature of C 'ef Building' Official ...date INSPECTION REQUEST LINE: (303)234 -5933 BUILDING OFFICE: (303)235-285S REQUESTS MUST BE MADE BY 3PM ANY BUSINESS. DAY FOR INSPECTION THE .FOLLOWING BUSINESS DAY. v COMMUNITY DEVELOPMENT DEPT. Inspection Services Division (303) 234 -5933 Inspection line (303) 235 -2855 Office c0 <ORP�� CORRECTION NOTICE ❑ Elec. ❑ Plumb. ❑ Mech. ❑ Structural Wither Brofst ❑ 2nd D 3rd Job Address: ❑ Re- inspection fee of $ must be paid prior to re- inspection. D Blocked Access D No one available for inspection: Time AM /PM *When corrections have been made, call for re-in at 303 - 2345933 Date: Inspector. DO N OT REMOVE THI OTICE COMMUNITY DEVELOPMENT DEPARTMENT Building Permit Number: 04 wHegT9 BUILDING INSPECTION LINE- 303. 234 -5933 , Date: $ CITY OF WHEAT RIDGE 7500 WEST 29TH AVENUE WHEAT RIDGE, CO 80033 - (303. 235 -2855) C OI ORPD APPLICATION Property Owner: Ai'.f c .-7 IC, Property Address: 4e/P16 3-IIJ5 � S1 Phone:? Contractor License No.: 7 Company: ��g �.[,t t Phone:P OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this permit application are Construction Value:$ :517 accurate, and do not violate applicable ordinances, rules or regulations of the City of Pemiit Fee:$ Wheat Ridge or covenants, easements orrestdctions of record; that all measurements Plan Review FOe:$ 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 t Jsc Tax - $ compliance with the Wheat Ridge Building Code (),1.B.C) and all other applicable Wheat Ridge Ordinances, for work . under this p t. - Total:$ (OWNER)(CONTRACTOR)[PRINTED Description: -7s ®" Sq. Ft. added / Z3 J S Expiration Date: Expiration Date: Expiration Date: Approval: Approval: Approval: (1) This permit was issued in accordance with the provisions set forth in your application and is subject to the laws of the State of Colorado and to the Zoning Regulations and Building Codes of W heat Ridge, Colorado or any other applicable ordinances of the City. (2) This permit shall expire if (A) the work authorized is not commenced within sixty (60) days from issue date or (B) the building authorized is suspended or abandoned for a period of 120 days. (3) If this permit expires, a new permit may be acquired for a fee of one -half the amount normally required, provided no changes have been or will be made in the original plans and specifications and any suspension or abandonment has not exceeded one (1) year. If changes have been or if suspension or abandonment exceeds one (1) year, full fees shall be paid for a new permit. (4) No work of any manner shall be done that will change the natural flow of water causing a drainage problem. (5) Contractor shall notify the Building Inspector twenty -four (24) hours in advance for all inspections and shall receive written approval on inspection card before proceeding with successive phases of the job. (6) The issuance of a permit or the approval of drawings and specifications shall not be construed to be a permit for, nor an approval of, any violation of the provisions of the building codes or any other ordinance, law, rule or regulation. Chief Building Official Electrical License No: Plumbing License No: Mechanical License No: Company: Company: Company: ' 41 City of Wheat Ridge r , Residential Mechanic PERMIT - 080636 .PERMIT NO: 080636 ` ISSUED: 06/12/2008 JOB ADDRESS: 4,215 BALSAM ST : EXPIRES: 12/09/2008 DESCRIPTION: Furnace replacement (80%) * ** CONTACTS * ** -Owner Brian Mason go .303/776 -5289 Didier Lecocq 08- .013.3 DDA Heating & Air * *..:PARCEL INFO ** ZONE CODE: UA USE: UA SUBDIVISION: .0325 BLOCK /LOT #: "0/ * *FEE SUMMARY ** ESTIMATED PROJECT VALUATION: 1,800.00 FEES :Permit Fee. LpA-oOVfLYJ 82.16 Total Valuation .00 - Use Tax 32.40 ** TOTAL ** '114.56 '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.(r.B.C) and all other - applicable Ridge Ordinances, for work under this permit. Plans subject to field inspection. /J Signature of contractor /owner date 1 This permit was issued in accordance with the provisions set forth in your application and is subject to the laws of the State of Colorado and to the Zoning Regulations and Building Codes of Wheat Ridge„ Colorado or any other applicable ordinances of the City. 2. This permit shall expire 180 days from the issue .date. Requests for an extension must be received prior to expiration'. date An extension may be granted at the discretion of the Building Official 3 If this permit expires, a new .permit may be acquired for afee of one. -half the .amount normally required, provided no `changes have been or will be 'made in the original plans and specifications and any suspension or abandonment has not exceeded: one .(1)year. -If - changes have been or if suspension or abandonment exceeds one (1) year, full .fees shall be paid for a new permit 4 No work of any manner shall be done that will change the naturalflow -of. water causing a drainage problem 5 Contractor shall notify the Building Inspector :twenty-four .(24): hours in advance for all inspections and shall receive written on - inspection card before proceeding . with successive phases of the job 6 The issuance of a_permit or the approval of drawings and specifications shall not be:. construed to be a permit for, nor an approval of, any violation of the provisions of the building codes or any other ordinance, .law, rule or regulation. All plan review is subject to field i s actions. 1 11 'Signature of Chief "Building Offi data INSPECTION 'REQUEST'. LI ..'(303)234 - .5933 - BUILDING OFFICE: (303).235 -2855 REQUESTS MUST BE MADE Y: 3PM ANY BUSINESS. DAY. FOR INSPECTION THE FOLLOWING BUSINESS DAY.. City of Wheat Ridge Building Division Date: 7500 W. 29" Ave., Wheat Ridge, CO 80033 Office: 303 - 235 -2855 * Fax: 303- 235 -2857 Plan #: °o <oRnoo Inspection Line: 303 - 234 -5933 Permit #: Building Permit Application Property Address: Property Owner (please print): g Ir lG In L " l C( S O 11 Phone: Mailing Address: (if different than property address) Address: 4,t City, State, Zip: W G( �Gf V t 4 �1(P f ( Contractor: Contractor License #: Phone: 30S 2-7 f —7 r 2 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): LkER -e ° 6f W construction value: $ 7 TO7 Description of work: �i b °?b� (as calculated per the Building Valuation Data sheet) r� MMnn Plan Review (due at time of submittal): $ Sq. Ft. /L.Ftadded: Squares BTU's �lu o 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 in ction. CIRLCE ONE:: ii (OWNER) I ( NTRACTOR or PERSONAL REPRESE W (CONTRATOR) /^� PRINT NAME: 6 l d (Z( C C d(1, a SIGNA E: �� ` Date: -12 -C/ ' ZONING COMMENTS: Zoning: Reviewer: PUBLIC WORKS COMMENTS: Reviewer: DEPARTMENT USE ONLY BUILDING DEPARTMENT COMMENTS: OCCUPANCY: Reviewer: FIRE DEPARTMENT:: ❑ approved w/ comments ❑ disapproved ❑ no review required